Fu Linda Y, Moon Rachel Y
Division of General Pediatrics and Community Health, Goldberg Center for Community Pediatric Health, Children's National Medical Center; George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Pediatr Rev. 2012 Aug;33(8):361-8; quiz 368-9. doi: 10.1542/pir.33-8-361.
Based on strong research evidence, the most common causes of apparent life-threatening events (ALTEs) are gastroesophageal reflux, lower respiratory tract infection, and seizure. • The minimum initial diagnostic panel for ALTE should include complete blood cell (CBC) count with differential; blood levels of C-reactive protein,glucose, sodium, potassium, urea, calcium,magnesium, ammonia, lactate, and pyruvate; arterial blood gas determination, urinalysis, and toxicology screen; electrocardiography; and assessments for Bordetella pertussis and respiratory syncytial virus in season. • Other testing should be done based on the infant’s clinical presentation and clinician’s degree of suspicion.• Most infants should be hospitalized for cardiorespiratory monitoring for 23 hours after an ALTE. • There is strong evidence that newborns are at higher risk of ALTE and sudden infant death syndrome (SIDS)within the first 24 hours after birth and therefore should be frequently monitored as much as possible while room sharing with their mothers. • Evidence suggests that maternal smoking may place an infant for higher risk of SIDS after an ALTE.
基于强有力的研究证据，明显危及生命事件（ALTEs）最常见的病因是胃食管反流、下呼吸道感染和癫痫发作。•ALTE的最低初始诊断检查项目应包括全血细胞计数及分类；C反应蛋白、血糖、钠、钾、尿素、钙、镁、氨、乳酸和丙酮酸的血药浓度；动脉血气测定、尿液分析和毒理学筛查；心电图；以及在流行季节检测百日咳博德特氏菌和呼吸道合胞病毒。•应根据婴儿的临床表现和临床医生的怀疑程度进行其他检查。•大多数婴儿在发生ALTE后应住院进行23小时的心肺监测。•有强有力的证据表明，新生儿在出生后的头24小时内发生ALTE和婴儿猝死综合征（SIDS）的风险较高，因此，在与母亲同室时，应尽可能频繁地对其进行监测。•有证据表明，母亲吸烟可能会使婴儿在发生ALTE后患SIDS的风险更高。
