[Study of risk factors for recurrence in severe life-threatening conditions in infants].
In a prospective study, 180 infants, mean age 2-6 months, hospitalized for apparent life threatening events between October 1985 and September 1988 (for 7,261 infants admitted into the pediatric unit during the same period), were submitted to the following investigations: careful anamnesis, complete clinical examination, systematic paraclinical investigations (standard biological studies, infectious and metabolic tests, investigations for gastro esophageal reflux (GER) and vagal hyper-reflectivity (VHR), polysomnography) or adapted to the clinical situation (toxic tests, brain computed scan, laryngoscopy, etc). Pathologies were mainly functional with neuro-vegetative immaturity (67.5%): gastro esophageal reflux (49%), vagal hyper-reflectivity (8.5%) or both (10%). An incidental pathological factor (breath holding spell, convulsion, intoxication, infection) was found in 18.5% of the infants, and 14% had normal results. Diphemanil 10 mg/kg/24h corrected the VHR and Metoclopramide 1 mg/kg/24h controlled 52% of the GER. The recurrence rate of illness in the GER and VHR groups was statistically lower with efficient therapy (12% vs 48%); no recurrence occurred in other groups.
Service de pédiatrie, Centre hospitalier général, Aix-en-Provence, France.
Y
Y
Rimet
A
A
Poujol
M A
MA
Cournelle
P
P
Cornus
D
D
Courcier
Y
Y
Brusquet
D003389:Cranial Nerve Diseases / Q000150:complications; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D007223:Infant; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D013575:Syncope / Q000209:etiology* / Q000628:therapy; D014630:Vagus Nerve / Q000503:physiopathology