Evaluation of High-Risk Infants With BRUE
Evaluation | Possible Etiologies |
|---|---|
Potential initial testing | |
Electrocardiogram | Inherited arrhythmia syndromes, other conduction abnormalities |
Pertussis testing | |
Cardiac and pulse oximetry monitoring in hospital | Arrhythmia, apnea/hypopnea, hypoxia |
Complete blood count and differential | Infection, anemia |
Cultures (blood, stool, urine, cerebrospinal fluid), urinalysis, lumbar puncture | Infection |
Nasal swab | Respiratory syncytial virus and other respiratory pathogens |
Electrolytes (magnesium, calcium, sodium, potassium), bicarbonate, and glucose | Dehydration, electrolyte derangement, acidosis, metabolic disorders |
Liver tests | Hepatobiliary disorders |
Toxicology screen | Medications, illicit drugs or other substances, or toxins |
Chest radiograph | Pneumonia, cardiomegaly |
Skeletal survey radiograph | |
Echocardiogram | Congenital heart disease, cardiomyopathy |
Additional tests based on clinical suspicion | |
Arterial blood gases, blood lactate, ammonia | Acidosis, metabolic disorders |
Genetic testing | Genetic/metabolic disorder |
Brain imaging (head CT, MRI) | Trauma, hemorrhage, tumor |
Electroencephalogram | |
Esophageal pH monitoring* | |
Upper gastrointestinal study with radioisotope milk scanning* | Gastroesophageal reflux disease |
Polysomnography or nocturnal oximetry | Sleep apnea/hypopnea (central or obstructive), nocturnal hypoxemia |
* In infants with a history of spitting up, gagging, vomiting, coughing, or difficulty feeding. | |
BRUE = brief, resolved, unexplained event. | |