Apparent Life-Threatening Event
Graham Jay
Introduction
An apparent life-threatening event (ALTE) in an infant is difficult to define precisely
Presents as an acute event that is:
Frightening to the observer
Has a defined onset and offset
Occurs suddenly and unexpectedly
A combination of apnea, color change, marked change in muscle tone, choking, and/or gagging
Often the infant will recover and appear normal when seen by prehospital providers or the physician
The description will often be given by frightened caregivers and may not be observed by hospital staff
Occurrence
0.6-0.8% of all emergency visits < 1 year age
˜ 2.5 per 1,000 live births
Most infants are under 12 months; mean age 13 weeks
Peak incidence 1 week-2 months of age
No seasonal variation
ALTE vs SIDS
Link between ALTE and subsequent SIDS (sudden infant death syndrome) is weak
Consider ALTE and SIDS as manifestations of different disease processes
The only prominent risk factor for both ALTE and SIDS is maternal smoking during pregnancy
In one retrospective study 15% of infants with SIDS had a history of ALTE
In a prospective study of infants with episodes of ALTE, 0% subsequently developed SIDS
History
Smoking: 60% of infants have a smoker within the home
GERD symptoms (32%), respiratory symptoms since birth (25%), recent fever (23%)Related posts:
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