The American Academy of Pediatrics has Changed 'ALTE' Terminology
HealthDay News — The new term, "brief resolved unexplained events" (BRUE), replaces the previous term, "apparent life-threatening events" (ALTE), per an expert panel from the American Academy of Pediatrics (AAP). The new AAP clinical guideline was published online April 25 in Pediatrics.
Joel Tieder, MD, MPH, associate professor of medicine at Seattle Children's Hospital and lead author of the new AAP clinical practice guideline, explained that the term ALTE was applied to these events back in the 1980s, when doctors thought they might be precursors to sudden infant death syndrome (SIDS). But ALTE was poorly defined and led to many children being hospitalized and receiving unnecessary testing, Tieder told HealthDay. Research has since determined that these events are not related to SIDS.
BRUE will be applied to cases based on more tightly defined criteria than those given to ALTE, Tieder said. Pediatricians can diagnose an event as BRUE only after performing a physical examination and taking a medical history, which is another marked change from the way ALTE was applied. Doctors often diagnosed ALTE based solely on what they were told by the parent or caregiver.
The AAP expert panel recommends against subjecting children with "low-risk" BRUE to hospitalization or testing. Infants with "high-risk" BRUE are those who were born premature; are younger than 2 months old; have had repeated BRUE episodes; have had an event that lasted longer than one minute or required cardiopulmonary resuscitation from a trained medical professional; or had a finding of concern in their physical exam or medical history. These "high-risk" children should be given a closer look, Tieder said.