Prematurity, Neonatology, SIDS. Jay Green Emergency Medicine Resident, PGY-2 July 19, 2007. Outline. Apparent Life-Threatening Events Sudden Infant Death Syndrome Other causes of apnea ± Quick snappers Won’t cover Fever/sepsis in the newborn Bronchopulmonary dysplasia Cerebral palsy
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Emergency Medicine Resident, PGY-2
July 19, 2007
National Institutes of Health Consensus Development
Conference on Infantile Apnea and Home Monitoring
See EM Reports Aug 7, 2006
National Institute of Child Health and Human Development
What is the most important modifiable risk factor?
Prone sleeping 78%17%, SIDS ↓ 40%!
Immature cardiorespiratory control
↓ baroreceptor reflex
↓central venous return, CO, bp
Is sleep ever bad…I guess so…
Exacerbate these effects
Poor lung perfusion hypoxia
Various badness that doesn’t help
-an excess of infants <1mo died
in sitting position compared to
-length of time in seat and
position may be NB contributors
Skopnik H et al.Effect of methylxanthines on periodic respiration and acid gastro-esophageal reflux in newborn infants. Monatsschrift Kinderheilkunde 1990;138(3):123-7