About 1 percent of all emergency room visits are prompted by near-death experiences in infants, such as extended periods without breathing or sudden changes in skin pallor or muscle tone. What causes these frightening experiences is often unknown, but the result can be long hospital stays and neurological impairment.
Now, a study of these apparent life-threatening events called ALTEs for short suggests that infants who experience them have abnormal regulation of esophageal and airway function compared to healthy babies. The findings, published online March 28 in the Journal of Pediatrics by a team in The Research Institute at Nationwide Children's Hospital, offer new information about the mechanisms behind ALTEs and what clinicians and parents can do to avoid them.
The research, led by Sudarshan Jadcherla, MD, principal investigator in the Center for Perinatal Research, compared 10 infants who experienced an ALTE and 10 healthy babies using innovative tools that track the concurrent functions of the infants' upper digestive tracts and airways. They found that infants with a previous near-death experience were more likely to have pauses in breathing, gasping breaths, less effective upper airway protection, delays in clearing their airways and difficulty coordinating swallowing and respiratory interactions.
"Previously, these life-threatening events were thought to be due to gastroesophageal reflux disease (GERD), and acid-suppressive treatment for that was often begun," says Dr. Jadcherla, who is also the director of the Neonatal and Infant Feeding Disorders Program and the Neonatal Aerodigestive Pulmonary Program at Nationwide Children's. "But our study identifies the dysfunctions in the aerodigestive tract instead of GERD-centered mechanisms as the real therapeutic targets for these babies."
Evaluating and accommodating these problems of esophageal function instead of initiating GERD medication (unless there
|Contact: Gina Bericchia|
Nationwide Children's Hospital