An apparent life-threatening event (ALTE) is a set of symptoms in an infant that cause the caregiver to believe the child may be dying or has died. It may include disturbed breathing, change in color, choking or gagging.
(CPR) may be needed at the time of the event.
Infant Airway and Lungs
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The cause of ALTE is not always clear. Some likely causes of ALTE may include:
Digestive problems, such as
gastroesophageal reflux disease
Neurological problems, such as a
or problems with the breathing center in the brain
Respiratory problems, such as lung infection or something blocking the airwayInfectionsHeart problems, such as an abnormal heartbeatProblems with the endocrine system, which includes the glands and hormones
Metabolic problems, such as
Boys and babies younger than 1 year of age are at higher risk of ALTE. Other factors that may increase an infant’s risk of ALTE include: Birth before 37 weeks gestationRespiratory syncytial virus
AnemiaGeneral anesthesiaFeeding problems, such as feeding too quickly, coughing, or choking during feedingSeizuresAbuse
Symptoms may include: Breathing that stopsChanges in skin color—blue, red, or paleChange in muscle tone—floppy or tenseChokingGagging
You will be asked about your baby’s symptoms and medical history, including what you noticed in the time leading up to the ALTE. A physical and neurological exam will be done. Your child's condition may need to be observed short term in the hospital and followed closely long term after discharge.
To look for potential causes of ALTE the doctor may order: Blood and urine tests may be done to look for infections or other problems in the body’s fluids.X-rays
and ultrasounds may also be done to take images of your baby’s bodily structures.
Other tests may include: Electrocardiogram
(EKG)—to look at the heart’s electrical activity for abnormal heart rhythm
(EEG)—to look for seizure activity in the brain
Talk with your doctor about the best treatment plan for your baby. Options include life-saving treatment if needed and treating the underlying cause of the ALTE. If the cause is unknown, treatment involves monitoring the child for symptoms.
CPR is a life-saving treatment that can be delivered by non-medical and medical people. It may restore breathing and blood circulation or help provide oxygen to the body until medical help arrives.
Consider taking a class in infant CPR so you are prepared.
If a cause is found, then the underlying condition will be treated.
In half of the babies who have an ALTE, the cause is not known. Home monitoring may be needed if advised by your baby’s doctor. A monitor can record your baby’s heart and breathing activity. An alert will sound if your baby is having another event. It may also sound for no reason (false positive)
There is no known way to prevent an ALTE.
ALTE—Apparent life-threatening event. Auckland District Health Board website. Available at: http://www.adhb.govt.nz/starshipclinicalguidelines/ALTE%20Apparent%20Life%20Threatening%20Event.htm. Updated April 2012. Accessed October 30, 2014.
Apparent life-threatening event. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 19, 2013. Accessed November 1, 2013.
Apparent life threatening event ALTE. The Royal Children’s Hospital Melbourne website. Available at: http://www.rch.org.au/clinicalguide/guideline_index/Apparent_Life_Threatening_Event_ALTE/. Accessed October 30, 2014.
Clinical practice guideline: apparent life threatening event (ALTE). Prince Margaret Hospital website. Available at: http://www.pmh.health.wa.gov.au/development/manuals/clinical_practice_guidelines/documents/alte_cpg.pdf. Updated January 2009. Accessed October 30, 2014.
Hall K, Zalman B. Evaluation and management of apparent life-threatening events in children. Am Fam Physician. 2005 June 15;71(12):2301-2308.
7/28/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Sarohia M, Platt S. Apparent life-threatening events in children: practical evaluation and management. 2014 Apr;11(4):1-14.
Last reviewed December 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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