Core Concepts
BRUE diagnosis and management in infants involves careful assessment and shared decision-making.
Abstract
The content discusses the evolution of terminology from apnea episodes to BRUE in infants, highlighting the challenges in defining and managing these events. It emphasizes the importance of shared decision-making and the limited utility of extensive testing in identifying underlying conditions. Key points include:
- Historical evolution of terminology from apnea episodes to BRUE.
- Criteria for defining a BRUE episode in infants.
- Challenges in determining recurrence risk and the need for hospitalization.
- Development of BRUE 2.0 criteria for focused risk assessment.
- Red flags indicating the need for further evaluation.
- Recommendations for neurological and GI evaluations.
- Emphasis on shared decision-making with families.
Stats
"In 2013, authors of a systematic review coined the term 'brief resolved unexplained event' (BRUE)."
"A BRUE recurred in 14.3% of the cohort, and 4.8% of high-risk infants were found to have a serious undiagnosed condition."
"Data from 2023 demonstrate that only 1.1% of lab tests following a BRUE contributed to a diagnosis."
Quotes
"As I reflect back on two and a half decades of caring for these patients, I believe that recent data have helped us a great deal."
"Nevertheless, looking for a few red flags, having a high index of suspicion when the clinical exam is abnormal, and engaging in shared decision-making with families can help make the caring for these challenging patients more bearable and lead to better outcomes for all involved."