Abstract

Introduction: an apparent life threatening event (ALTE) is a variable combination of apnea, change in colour and of the muscle tone that frightens the observer. It usually affects infants. The Emergency Department physician in charge needs a briefing on handling these patients. Objective: to assess the etiologies and recommended management of young children with ALTE by means of a protocol. Material and methods: a prospective study on infants with ALTE admitted to an Emergency Department from may 2002 to may 2003. A protocol was designed, including description of the episode, background and further diagnostic studies. Results: 46 patients with ALTE whose mean age was 12 weeks presented with: apnea and changes in colour (100%), hypotonic muscle tone (85%) and in 96% Cardiopulmonary Resuscitation was performed. Main etiologies found were respiratory tract infections (54%); Gastroesophageal reflux (15%), convulsions (9%), urinary tract infections (7%). 3 patients died and five were monitored at home on follow-up. Conclusions: main causes of ALTE found were respiratory tract infections, gastroesophageal reflux and convuisions. Our protocol is useful in the correct diagnostic procedures management, treatment and home monitoring.