ABSTRACT
El síndrome de muerte súbita del lactante (SMSL) consiste en la muerte inesperada de un infante menor de un año, la cual no puede ser explicada posterior a las investigaciones del caso, tales como: la anamnesis, la escena de la muerte, y la autopsia. La relevancia de este padecimiento radica en que es un fenómeno presente a nivel mundial, y es la principal causa de muerte en lactantes de 1 a 12 meses de vida. Debido a la importancia del tema, la presente investigación pretende realizar un acercamiento bibliográfico, que aborda terminología especializada; estudios de epidemiologia a nivel mundial; diversos factores de riesgo y su prevención; además del algoritmo de manejo de SMSL basado en las guías españolas de pediatría y las guías de SMSL de Massachusetts.Cabe destacar que el diagnóstico de esta muerte es de exclusión y requiere una investigación exhaustiva para poder dilucidar sus causas. Así mismo, el SMSL ha sido asociado a diferentes factores de riesgo que pueden desencadenar este evento en niños con susceptibilidad genética o adquirida, los cuales en la mayoría de los casos pueden modificarse y prevenirse educando a los padres, y a los proveedores de la salud. Debido a que el médico general, y el pediatra son los primeros profesionales en abordar al lactante y a sus familiares, es imperativo que ambos tengan conocimiento del tema en cuestión, no solo para la prevención de estos casos, sinopara el abordaje correcto en el caso que se presente una muerte súbita infantil.
Sudden Infant Death Syndrome (SIDS) is defined as the sudden death of an infant less than 1 year of age that cannot be explained after a thorough investigation is conducted, including the review of the clinical history, the examination of the death scene, and an autopsy. This condition is relevant because is a worldwide phenomenon, and it is the leading cause of death in infants between 1 to 12 months. Due to the importance of this subject, this research tries to make a bibliographic review that includes specialized terminology, worldwide epidemiology studies, risk factors, how to prevent it; and the approach, based on the Spanish and Massachusetts guidelines.The diagnosis of SIDS is based in the exclusion of causes, and requires a thorough investigation to elucidate them. Also, SIDS has been associated with different risk factors that can trigger this event in children with genetic or acquired susceptibility, which in most cases can be modified and prevented by educating the parents and the health care providers. Because the physician and the pediatrician are the first professionals to have contact with the infant and their families, it is imperative that both have knowledge of this subject, not only for the prevention of such cases, but for the correct approach in these cases.
Subject(s)
Humans , Male , Female , Death, Sudden , InfantABSTRACT
PURPOSE: The purpose of this study is to analyze the epidemiologic characteristics of sudden unexpected death in infancy and to evaluate the importance of postmortem autopsy. METHODS: We reviewed, retrospectively, medical records of 34 infants admitted to Kangnam General Hospital from January 1987 to December 2001 because of sudden unexpected death. We investigated the cause of death through medical history, death scene examination, autopsy findings, acylcarnitine and organic acid analysis. RESULTS: Among the total 34 infants, 18 were male(52.9%) and 16 were female(47.1%). Thirty infants(88%) were below the six months of age. Winter was the most affected season(38.2%). Eighteen infants(52.9%) died between 6 and 12AM. The prone sleeping position was observed more frequently than the supine position at death; nine cases in the prone position, six cases in the supine position. The cause of death of 23 cases could not be found by only history and death scene examination. Autopsy was done in 13 cases. Seven cases of them were thought to be SIDS. In six cases, we explained the cause of death with autosy findings. They were an endocardial fibroelastosis, a nesidioblastosis, a subdural hematoma, a bronchopneumonia and two fatty changes of liver. Metabolic screening tests performed in three cases to rule out metabolic disorder since 2000 were all normal. CONCLUSION: We concluded that autopsy and metabolic screening test should be performed to find out the cause of death in sudden unexpected death in infancy.