Sudden Infant Death Syndrome

Published on 21/03/2015 by admin

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Last modified 21/03/2015

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Chapter 74 Sudden Infant Death Syndrome


Sudden infant death syndrome (SIDS) is defined as “the sudden death of an infant under 1 year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history” (Willinger, James, & Catz, 1991, p. 681). The autopsy report can include the following findings. External examination reveals a body that appears well developed and nourished. There is a small amount of mucous, or watery or bloody secretions present at the nares. Cyanosis of the lips and nail beds is almost always present. The internal examination findings indicate a subacute inflammation of the upper respiratory tract and petechiae on the pleura, the pericardium, and the thymus (this is found in 80% of cases). There is pulmonary edema and congestion. The autopsy reveals symptoms of chronic hypoxemia including brainstem changes; persistence of brown fat, especially around the adrenals; and hepatic erythropoiesis. Some of these autopsy findings are demonstrated in about 80% of SIDS cases, and their absence does not exclude the diagnosis. Risk factors associated with the incidence of SIDS are listed in Box 74-1.

The pathophysiology of SIDS remains unclear, but current research is focused in the following six areas: