Document Detail

Delayed death in sudden infant death syndrome: a San Diego SIDS/SUDC Research Project 15-year population-based report.
MedLine Citation:
PMID:  17988810     Owner:  NLM     Status:  MEDLINE    
A fraction of SIDS cases have death delayed by successful CPR, yet they have not been compared to SIDS cases which were found dead or not successfully resuscitated. Our aims were to: (1) determine the percent of SIDS cases in the San Diego SIDS Research Project database for whom death was delayed by CPR and subsequent life support; (2) compare demographics, circumstances of death and autopsy findings of delayed death SIDS cases (delayed SIDS) with those whose deaths were not delayed (non-delayed SIDS); (3) examine the evolution of pathologic changes in delayed SIDS as a function of survival interval. A retrospective 15-year population-based study of 454 infant deaths attributed to SIDS revealed 29 delayed SIDS cases (Group I) and 425 non-delayed SIDS cases (Group II). Group I cases were significantly older than Group II cases (mean age 132 days vs. 102 days and p<0.0001). Eighty-nine percent of the Group I cases were discovered between 08.00 and 19.59 h; none were found between 00.00 and 07.59 h, compared to 38% of the Group II cases. Group I infants were found significantly more often away from home (at daycare, or at the home of a relative, friend, or baby sitter) than Group II infants (45% vs. 25%, p<0.05). There were no differences between groups with regard to gender, gestational age, type of delivery, bed sharing, URI within 48 h of death, ALTEs, a history of referral to child protective services, body position when placed or found, or face position when found. Pathologic changes were semiquantitatively evaluated; findings were characteristic of anoxic-ischemic injury that generally became more severe with increasing survival intervals. Anoxic-ischemic brain injury was the immediate cause of death in all delayed SIDS cases. Aspiration of gastric contents was identified in Group I cases surviving less than 48 h and was the likely etiology of acute bronchopneumonia occurring in 83% of the Group I cases. We did not identify factors that would reliably predict which SIDS cases might be discovered soon enough to allow earlier and more effective CPR and survival without permanent brain injury.
Henry F Krous; Elisabeth A Haas; Amy E Chadwick; Homeyra Masoumi; Anna Mhoyan; Christina Stanley
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-11-07
Journal Detail:
Title:  Forensic science international     Volume:  176     ISSN:  1872-6283     ISO Abbreviation:  Forensic Sci. Int.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-04     Completed Date:  2008-04-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902034     Medline TA:  Forensic Sci Int     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  209-16     Citation Subset:  IM    
Rady Children's Hospital & Health Center, San Diego, CA 92123, USA.
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MeSH Terms
Age Distribution
Bronchopneumonia / mortality,  pathology
California / epidemiology
Cardiopulmonary Resuscitation*
Databases, Factual
Forensic Medicine
Gliosis / pathology
Hemorrhage / pathology
Hypoxia-Ischemia, Brain / mortality,  pathology
Infant, Newborn
Life Support Care*
Lung / pathology
Purpura / pathology
Respiratory Aspiration / pathology
Retrospective Studies
Sudden Infant Death / epidemiology*
Thymus Gland / pathology
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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