SIDS Conference in Yokohama
This conference included an interesting abstract:
CARDIORESPIRATORY RECORDINGS DURING SUDDEN INFANT DEATH (SID)
The pathomechanisms leading to SID are still unknown. One way to gain more insights into these is an analysis of memory monitor downloads. There are now a number of recordings from cardiorespiratory monitors which were obtained during SID. In an analysis of 9 recordings of chest wall impedance and heart rate obtained during SID, gasping was the predominant pattern, being already present at the time of the monitor alarm in 3 infants and occurring within 3 min. after it in a further 4. One infant only began to gasp 13 min. after the first monitor alarm. The duration of gasping ranged from 3 s to 11 min. Primary trigger for the monitor alarm had been bradycardia in all but two infants, but there was no indication of heart block or ventricular tachycardia. Prolonged apnea (>20 s) began only up to 13.7 min. (median 2.7) after this alarm in 5 infants and 7 to 20 s before it in 3; in the remaining infant, stimulation occurred prior to any apnea. There was no evidence for any arousal reaction (e.g., body movements). These observations suggest that prolonged apnea is unlikely to be a primary mechanism in the sequence of events leading to most cases of SID. Also, bradycardia is unlikely to be a primary mechanism, as it was closely related to gasping, which is indicative of severe hypoxemia (triggering the bradycardia). Finally, gasping occurred in the majority of these SID victims, but was obviously not successful as an autoresuscitative mechanism. The latter data were confirmed in a similar study observing gasping in 23 of 24 infants immediately preceding death. These data differ from those obtained during imposed apnea (infanticide), which may show initial tachycardia. These data will be compared with a polygraphic video recording of an infant during a severe ALTE who showed similar respiratory patterns.
I would feel uncomfortable if a baby died from SIDS in hospital when simply being monitored unless all possible efforts were made to prevent this from happening.