Introduction: The term BRUE (Brief Resolved Unexplained Event) appeared in the recommendations of the American Academy of Pediatrics (AAP) in May 2016, replacing the term ALTE (Apparent Life-Threatening Event), in order to change the diagnostic approach of these events, namely in patients who were at low risk for subsequent episodes or underlying disease.
Objectives: This study aims to characterize inpatients in the pediatric service of a tertiary hospital, diagnosed with BRUE, as well as to verify their correct evaluation and guidance, according to the AAP guidelines.
Methods: A retrospective observational study using data obtained by consulting the clinical files of inpatients diagnosed with BRUE, between May 2016 and December 2018.
Results / Conclusions: 39 patients were included, with an average age of 37.9 days (minimum 2 and maximum 130 days), 51% (n = 20) being male. The cause for the event was identified in 13 cases (33.3%), the choking being the most frequent. Two patients (7.6%) met the low-risk BRUE criteria. As a form of presentation, 11 (28%) presented apnea, 15 (38%) hypertonia and 16 (41%) cyanosis. All patients classified as high risk BRUE (n = 24) underwent electrocardiogram (ECG), echocardiogram and analytical study, 20 (83.3%) underwent electroencephalogram (EEG) and transfontanellar ultrasound and 14 (58.3%) chest radiography. In cases of low-risk BRUE, all underwent ECG, echocardiogram, analytical study, EEG and chest radiography.
During the collection of clinical history, the difficulty in characterizing some events hindered the correct diagnosis and/or stratification of the BRUE, often conditioning hospitalization and the performance of unnecessary complementary diagnostic tests.
Key words: BRUE, high risk, low risk, inpatient children, investigation
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