Original articleAspiration of Gastric Contents in Sudden Infant Death Syndrome without Cardiopulmonary Resuscitation
Section snippets
Methods
The Rady Children’s Hospital-Health Center Institutional Review Board approved this study. A search of the records of all postneonatal infants (29-365 days of age) dying suddenly and unexpectedly who were autopsied at the Medical Examiner’s Office in San Diego County, California, between January 1, 1991 and December 31, 2004 and accessioned into the San Diego SIDS Research Project database at Children’s Hospital-San Diego revealed 69 cases of infants who had a diagnosis of SIDS and had not
Results
Group I (SIDS cases with aspiration) includes 10 (14%) of the 69 cases. No demographic findings were significantly different between the two groups (Table I). The majority of infants in both groups were male, born term, delivered vaginally, and fed formula as their last meal. None of the infants who were breast-fed for their last meal had evidence of gastric aspiration. Clinically documented gastroesophageal reflux (GER) was more common in cases with aspiration (20% vs 2%); a history of apnea
Discussion
Prone sleep position has been long recognized as one of the most important risk factors for SIDS.6, 7, 8, 9, 10 Adoption of the supine sleep position as recommended in the Back to Sleep campaign and other similar public education programs has resulted in a dramatic reduction in the incidence of SIDS.9, 11, 12 However, some segments of the population have not followed the supine sleep recommendation, causing disparities in the decreasing rates of SIDS.13, 14, 15, 16 Fear of gastric aspiration
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2010, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :Cruz et al. [25] support tracheotomy as the method of airway intervention which will completely resolve significant obstruction while causing the least disruption to oro-motor mechanics, thereby enhancing the child's potential to overcome feeding difficulties. Our finding that GER is significantly related to penetration is well supported by the literature [9,26–29]. Many children who are at risk for aspiration undergo surgical intervention, such as a fundoplication, to reduce their chances of aspiration pneumonia.
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Grant support from the CJ Foundation for SIDS and First Candle/SIDS Alliance. Donations from the San Diego Guild for Infant Survival, the Orange County Guild for Infant Survival, and the San Diego SIDS/SUDC Research Project.