The cardiorespiratory control hypothesis for sudden infant death syndrome.

One or more abnormalities in cardiorespiratory control is the most compelling explanation for SIDS. Elucidation of the interrelationships between arousal responsiveness and gasping may be crucial to a better understanding of SIDS pathophysiology. The complex interactions need to be examined between arousal, autoresuscitation, and the other components of cardiorespiratory control. Prospective identification trials will be difficult since no cardiorespiratory control parameter yet identified has sufficient sensitivity and specificity, and trials assessing multiple parameters will be costly and cumbersome. Furthermore, prospective identification will be worthwhile only if an effective intervention has been established. To the extent that SIDS deaths still occur during documented monitoring, detailed analyses of the recorded cardiorespiratory events should finally provide us with objective data as to the terminal pathophysiologic events in SIDS victims and their relationship to aberrant cardiorespiratory control.