Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach.

Autor: Prezioso G; Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Perrone S; Unit of Neonatology, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Biasucci G; Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29122 Piacenza, Italy., Pisi G; Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Fainardi V; Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Strisciuglio C; Department of Woman, Child and General and Specialistic Surgery, University of Campania 'Luigi Vanvitelli', 80138 Naples, Italy., Marzano FN; Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, 43126 Parma, Italy., Moretti S; Unit of Neonatology, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Pisani F; Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Tchana B; Cardiology Unit, Parma Hospital, 43126 Parma, Italy., Argentiero A; Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Neglia C; Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Caffarelli C; Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Bertolini P; Oncohematology Unit, Parma Hospital, 43126 Parma, Italy., Bersini MT; Primary Care Pediatrics, AUSL of Parma, 43126 Parma, Italy., Canali A; Primary Care Pediatrics, AUSL of Parma, 43126 Parma, Italy., Voccia E; Primary Care Pediatrics, AUSL of Parma, 43126 Parma, Italy., Squarcia A; Unit of Neuropsychiatry of Children and Adolescents, AUSL Parma, 43126 Parma, Italy., Ghi T; Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Verrotti C; Woman Health Unit, AUSL Parma, 43126 Parma, Italy., Frusca T; Obstetrics and Gynaecology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Cecchi R; Legal Medicine Section, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Giordano G; Pathology Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Colasanti F; Unit of Neonatology, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Roccia I; Unit of Neonatology, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Palanza P; Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy., Esposito S; Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Jazyk: angličtina
Zdroj: Life (Basel, Switzerland) [Life (Basel)] 2021 Feb 22; Vol. 11 (2). Date of Electronic Publication: 2021 Feb 22.
DOI: 10.3390/life11020171
Abstrakt: Unexpected events of breath, tone, and skin color change in infants are a cause of considerable distress to the caregiver and there is still debate on their appropriate management. The aim of this study is to survey the trend in prevention, decision-making, and management of brief resolved unexplained events (BRUE)/apparent life-threatening events (ALTE) and to develop a shared protocol among hospitals and primary care pediatricians regarding hospital admission criteria, work-up and post-discharge monitoring of patients with BRUE/ALTE. For the study purpose, a panel of 54 experts was selected to achieve consensus using the RAND/UCLA appropriateness method. Twelve scenarios were developed: one addressed to primary prevention of ALTE and BRUE, and 11 focused on hospital management of BRUE and ALTE. For each scenario, participants were asked to rank each option from '1' (extremely inappropriate) to '9' (extremely appropriate). Results derived from panel meeting and discussion showed several points of agreement but also disagreement with different opinion emerged and the need of focused education on some areas. However, by combining previous recommendations with expert opinion, the application of the RAND/UCLA appropriateness permitted us to drive pediatricians to reasoned and informed decisions in term of evaluation, treatment and follow-up of infants with BRUE/ALTE, reducing inappropriate exams and hospitalisation and highlighting priorities for educational interventions.
Databáze: MEDLINE
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