A clinical practice guideline from the American Academy of Pediatrics recommends a new term for brief events in infants – such as when an infant stops breathing for a few seconds -- that are rarely associated with underlying medical problems or risk to the infant.
The new term, "brief resolved unexplained event," or BRUE, will replace the older term, "apparent life-threatening event" (ALTE).
The guidelines, "The Evaluation and Management of Brief Resolved Unexplained Events (Formerly Called Apparent Life Threatening Events)" will be published in the May 2016 Pediatrics (published online April 25).
The guidelines apply to well-appearing infants up to 12 months old who experience an event that lasts less than a minute and then resolves itself during which they exhibit one or more of the following symptoms:
- Blue or pale complexion
- Absent or irregular breathing
- Marked change in muscle tone
- Altered level of responsiveness
In the past, an infant brought to the hospital after an event like this may have been hospitalized and subjected to multiple lab tests, imaging studies and other diagnostic procedures – all of which carry their own risks, but do not necessarily lead to a treatable diagnosis or prevent future events.
According to the new guidelines, unless the infant has other identifiable risk factors, such as a fever or medical history, further diagnostic tests or procedures are not useful or necessary. The guidelines are based on a comprehensive review of literature related to ALTEs from 1970 through 2014. The new term "brief, resolved, unexplained event" better reflects the transient nature and lack of clear cause of such events, which are rarely life-threatening under the BRUE definition.