Aspiration of Gastric Contents in Sudden Infant Death Syndrome without Cardiopulmonary Resuscitation

• Published in: The Journal of pediatrics Vol. 150; no. 3; pp. 241 - 246
• Main Authors: Krous, Henry F., MD, Masoumi, Homeyra, MD, Haas, Elisabeth A., MPH, Chadwick, Amy E., BA, Stanley, Christina, MD, Thach, Bradley T., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-03-2007; Elsevier
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Autopsy; Biological and medical sciences; Biopsy, Needle; Cardiopulmonary Resuscitation; Cohort Studies; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Female; Gastrointestinal Contents; General aspects; Humans; Immunohistochemistry; Infant; Infant, Newborn; Intensive care medicine; Lung - pathology; Male; Medical sciences; Pediatrics; Probability; Prone Position; Respiratory Aspiration - complications; Retrospective Studies; Sudden Infant Death - etiology; Sudden Infant Death - prevention & control; Supine Position; ALTEs; Gastroesophageal reflux; SIDS; CPR; GER; Cardiopulmonary resuscitation; Sudden infant death syndrome; Apparent life-threatening events; Human; Stomach; Pediatrics; Intensive cardiocirculatory care; Cardiocirculatory arrest; Digestive system; Aspiration; Sudden death; Content; Cardiovascular disease; Infant
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2006.12.012

Objectives (1) To compare demographic profiles among sudden infant death syndrome (SIDS) infants with or without gastric aspiration, for whom cardiopulmonary resuscitation (CPR) had not been attempted; (2) to review the severity and potential significance of aspiration in those SIDS cases; and (3) to assess the risk of supine sleep position with regard to gastric aspiration. Study design Retrospective review of records and microscopic slides for all postneonatal SIDS cases (29 to 365 days of age) accessioned by the San Diego County Medical Examiner from 1991 to 2004. Results Ten (14%) of 69 cases of SIDS infants who had not undergone CPR before autopsy revealed microscopic evidence of gastric aspiration into the distal lung; this group was not otherwise clinically or pathologically different from cases of SIDS infants without aspiration. Similar proportions of infants were found supine or prone, regardless of gastric aspiration. Conclusions Gastric aspiration is not uncommon in infants dying of SIDS, and supine sleep position does not increase its risk. Gastric aspiration may be a terminal event that some infants, representing a subset of SIDS cases, cannot overcome.