Clinical Characteristics of Toddlers with Apparent - Life Threatening Events

Abstract

Background: Apparent-life threatening events (ALTE) are a frequent cause of hospitalization.

Objective: To describe the characteristics of these patients, establish main diagnosis, evaluating the clinical evolution and Sudden Infant Death Syndrome.

Patients and Methods: 120 patients hospitalized between May 2001 and June 2004 at Luis Calvo Mackenna Children’s Hospital and followed in our Apnea Clinic. According to the recommendations of the American Academy of Pediatrics, they were studied with blood count, blood gases and plasmatic electrolytes. According to clinical orientation, other studies were performed like 24 hours pH - esophagic probe, metabolic tests, respiratory viral immunofluorescence, encephalic ultrasound and EEG. A 24-hours cardiorespiratory monitorization was done, demonstrating the presence of apnea.

Results: 52% were men, mean age 2,5 months (48% newborns). The usual presentations were apnea (76%), cyanosis (75%), hypotonia (36%) and pallor (23%). 37,8% of patients had gastroesophageal reflux, 14% respiratory infections, 13% idiopathic apnea, 11% seizures and 6% preterm apnea.

Conclusions: The most frequent causes of ALTE are gastroesophageal reflux and respiratory infections. During the study period no patient died; it seems that there is no relationship between infant’s apnea and sudden infant death syndrome.