User:Mr. Ibrahem/Brief resolved unexplained event

Brief resolved unexplained event (BRUE), previously apparent life-threatening event (ALTE), is a short event that has resolved in a child less than one year old. The event may include a lack of breathing, skin color change, weakness, decreased responsiveness, or gagging. The event causes concern to those who observe it.

By definition, the cause in unknown despite a medical assessment. Those at low risk include children older than 60 days, born after 32 weeks gestational age, first event, symptoms of less than one minute, with no concerning findings on exam. In this group no specific testing is needed. Some cases may be related to reflux, seizures, bronchiolitis, inborn errors of metabolism, heart arrhythmias, and child abuse.

In those at low risk an hour or two of observation with pulse oximetry is all that is required. In those with high risk features an EKG and testing for pertussis may be performed. Additional test may be done on a case by case basis. Those with more than one even in 24 hours may be admitted for observation.

Brief resolved unexplained events affects about 0.6 to 2.6 per 1,000 babies. The risk of death is similar to that of unaffected children, at less than 1% over the subsequent year. In 2016 the term BRUE replaced the term ALTE.