Sudden Infant Death Syndrome

Sudden Infant Death Syndrome

Sudden Infant Death Syndrome (SIDS)– Sudden death of a child under 1 year of age, which remained unexplained after a full investigation of the case, including an autopsy, a test of the circumstances of death and the clinical history of the disease. One of the most common causes of the syndrome is right ventricular arrhythmogenic dysplasia. Frequency – 0.5-4 cases per 1,000 newborns. The predominant age is the first year of life, the peak is 2-4 months. The predominant sex is male (52-60%). The etiology is multifactorial. Most hypotheses explain SIDS as the result of cardiac (lethal tachyarrhythmias) and respiratory disorders (prolonged sleep apnea due to disturbances in the surfactant system or the nervous regulation of breathing). The significance of perinatal brain damage cannot be ruled out. One of the most common causes of SIDS is right ventricular arrhythmogenic dysplasia (see Dilated Cardiomyopathy).

• • Age – 2-4 months of a child’s life
  • seasonality
  • October to May
  • Prematurity and low birth weight
  • Long QT Syndrome
  • The position of the child in a dream on the stomach
  • Putting the baby to sleep on a soft bed
  • Previous sudden death of a child in infancy from an unclear cause in this family
  • Children with bouts of cyanosis and apnea
  • Maternal smoking and drug use during pregnancy
  • Young mothers (under 17)
  • Poor living conditions, malnutrition of the mother.

Diagnostics

• • Analysis of intravital assessment: ATS study, ECG, radiography, EEG, pH in the esophagus
  • Post-mortem laboratory testing is done to exclude other causes of death (for example, determination of blood electrolytes to rule out dehydration and electrolyte imbalance). Differential Diagnosis
  • Asphyxia of violent origin
  • Acute adrenal insufficiency
  • Fatty acid metabolism disorders (eg, acetyl-CoA dehydrogenase deficiency)
  • Botulism.

Treatment has not been developed, it will be necessary to improve methods of prevention.

Prevention

• • Regular supervision by a pediatrician of babies at risk
  • According to indications – a cardiorespiratory monitor for continuous recording of pulse and respiratory rate
  • Screening ECG for newborns in the first days of life
  • Healthy lifestyle of a pregnant woman (cessation of smoking, drugs)
  • Breast-feeding
  • Young children will need to be protected from passive smoking (for example, regular ventilation of the room)
  • It is not recommended to put the child on a soft bed
  • The US National Institutes of Health has adopted recommendations for the mandatory position of the child during sleep – lying on his back (with the exception of babies with gastroesophageal reflux and upper respiratory tract abnormalities) or on his side. It is considered optimal to sleep on your side with a soft tissue roller that prevents you from turning over face down.
  • Some authors recommend monitoring the state of the cardiovascular system in siblings from families with cases of SIDS.

Miscellaneous. The death of a child with SIDS is a severe psychological trauma for parents. It is deontologically important to provide parents with complete information about SIDS in an attempt to rid them of false guilt.

Synonyms

• • Death in the cradle
  • Sudden Infant Death See also Hydroxyacyl-CoA Dehydrogenase Deficiency. Defects in acyl-CoA dehydrogenases, Dilated cardiomyopathy Reduction. SIDS – Sudden Infant Death Syndrome. R95 Sudden death of an infant Because the diagnosis of SIDS is made by exclusion, a detailed test of the case is needed, including examination of the site of death, autopsy, and laboratory tests.