Cargando…

Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach

Unexpected events of breath, tone, and skin color change in infants are a cause of considerable distress to the caregiver and there is still debate on their appropriate management. The aim of this study is to survey the trend in prevention, decision-making, and management of brief resolved unexplain...

Descripción completa

Detalles Bibliográficos
Autores principales: Prezioso, Giovanni, Perrone, Serafina, Biasucci, Giacomo, Pisi, Giovanna, Fainardi, Valentina, Strisciuglio, Caterina, Marzano, Francesco Nonnis, Moretti, Sabrina, Pisani, Francesco, Tchana, Bertrand, Argentiero, Alberto, Neglia, Cosimo, Caffarelli, Carlo, Bertolini, Patrizia, Bersini, Maria Teresa, Canali, Andrea, Voccia, Emanuele, Squarcia, Antonella, Ghi, Tullio, Verrotti, Carla, Frusca, Tiziana, Cecchi, Rossana, Giordano, Giovanna, Colasanti, Filomena, Roccia, Ilenia, Palanza, Paola, Esposito, Susanna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926945/
https://www.ncbi.nlm.nih.gov/pubmed/33671771
http://dx.doi.org/10.3390/life11020171
_version_ 1783659579224096768
author Prezioso, Giovanni
Perrone, Serafina
Biasucci, Giacomo
Pisi, Giovanna
Fainardi, Valentina
Strisciuglio, Caterina
Marzano, Francesco Nonnis
Moretti, Sabrina
Pisani, Francesco
Tchana, Bertrand
Argentiero, Alberto
Neglia, Cosimo
Caffarelli, Carlo
Bertolini, Patrizia
Bersini, Maria Teresa
Canali, Andrea
Voccia, Emanuele
Squarcia, Antonella
Ghi, Tullio
Verrotti, Carla
Frusca, Tiziana
Cecchi, Rossana
Giordano, Giovanna
Colasanti, Filomena
Roccia, Ilenia
Palanza, Paola
Esposito, Susanna
author_facet Prezioso, Giovanni
Perrone, Serafina
Biasucci, Giacomo
Pisi, Giovanna
Fainardi, Valentina
Strisciuglio, Caterina
Marzano, Francesco Nonnis
Moretti, Sabrina
Pisani, Francesco
Tchana, Bertrand
Argentiero, Alberto
Neglia, Cosimo
Caffarelli, Carlo
Bertolini, Patrizia
Bersini, Maria Teresa
Canali, Andrea
Voccia, Emanuele
Squarcia, Antonella
Ghi, Tullio
Verrotti, Carla
Frusca, Tiziana
Cecchi, Rossana
Giordano, Giovanna
Colasanti, Filomena
Roccia, Ilenia
Palanza, Paola
Esposito, Susanna
author_sort Prezioso, Giovanni
collection PubMed
description Unexpected events of breath, tone, and skin color change in infants are a cause of considerable distress to the caregiver and there is still debate on their appropriate management. The aim of this study is to survey the trend in prevention, decision-making, and management of brief resolved unexplained events (BRUE)/apparent life-threatening events (ALTE) and to develop a shared protocol among hospitals and primary care pediatricians regarding hospital admission criteria, work-up and post-discharge monitoring of patients with BRUE/ALTE. For the study purpose, a panel of 54 experts was selected to achieve consensus using the RAND/UCLA appropriateness method. Twelve scenarios were developed: one addressed to primary prevention of ALTE and BRUE, and 11 focused on hospital management of BRUE and ALTE. For each scenario, participants were asked to rank each option from ‘1’ (extremely inappropriate) to ‘9’ (extremely appropriate). Results derived from panel meeting and discussion showed several points of agreement but also disagreement with different opinion emerged and the need of focused education on some areas. However, by combining previous recommendations with expert opinion, the application of the RAND/UCLA appropriateness permitted us to drive pediatricians to reasoned and informed decisions in term of evaluation, treatment and follow-up of infants with BRUE/ALTE, reducing inappropriate exams and hospitalisation and highlighting priorities for educational interventions.
format Online
Article
Text
id pubmed-7926945
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-79269452021-03-04 Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach Prezioso, Giovanni Perrone, Serafina Biasucci, Giacomo Pisi, Giovanna Fainardi, Valentina Strisciuglio, Caterina Marzano, Francesco Nonnis Moretti, Sabrina Pisani, Francesco Tchana, Bertrand Argentiero, Alberto Neglia, Cosimo Caffarelli, Carlo Bertolini, Patrizia Bersini, Maria Teresa Canali, Andrea Voccia, Emanuele Squarcia, Antonella Ghi, Tullio Verrotti, Carla Frusca, Tiziana Cecchi, Rossana Giordano, Giovanna Colasanti, Filomena Roccia, Ilenia Palanza, Paola Esposito, Susanna Life (Basel) Article Unexpected events of breath, tone, and skin color change in infants are a cause of considerable distress to the caregiver and there is still debate on their appropriate management. The aim of this study is to survey the trend in prevention, decision-making, and management of brief resolved unexplained events (BRUE)/apparent life-threatening events (ALTE) and to develop a shared protocol among hospitals and primary care pediatricians regarding hospital admission criteria, work-up and post-discharge monitoring of patients with BRUE/ALTE. For the study purpose, a panel of 54 experts was selected to achieve consensus using the RAND/UCLA appropriateness method. Twelve scenarios were developed: one addressed to primary prevention of ALTE and BRUE, and 11 focused on hospital management of BRUE and ALTE. For each scenario, participants were asked to rank each option from ‘1’ (extremely inappropriate) to ‘9’ (extremely appropriate). Results derived from panel meeting and discussion showed several points of agreement but also disagreement with different opinion emerged and the need of focused education on some areas. However, by combining previous recommendations with expert opinion, the application of the RAND/UCLA appropriateness permitted us to drive pediatricians to reasoned and informed decisions in term of evaluation, treatment and follow-up of infants with BRUE/ALTE, reducing inappropriate exams and hospitalisation and highlighting priorities for educational interventions. MDPI 2021-02-22 /pmc/articles/PMC7926945/ /pubmed/33671771 http://dx.doi.org/10.3390/life11020171 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Prezioso, Giovanni
Perrone, Serafina
Biasucci, Giacomo
Pisi, Giovanna
Fainardi, Valentina
Strisciuglio, Caterina
Marzano, Francesco Nonnis
Moretti, Sabrina
Pisani, Francesco
Tchana, Bertrand
Argentiero, Alberto
Neglia, Cosimo
Caffarelli, Carlo
Bertolini, Patrizia
Bersini, Maria Teresa
Canali, Andrea
Voccia, Emanuele
Squarcia, Antonella
Ghi, Tullio
Verrotti, Carla
Frusca, Tiziana
Cecchi, Rossana
Giordano, Giovanna
Colasanti, Filomena
Roccia, Ilenia
Palanza, Paola
Esposito, Susanna
Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach
title Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach
title_full Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach
title_fullStr Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach
title_full_unstemmed Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach
title_short Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach
title_sort management of infants with brief resolved unexplained events (brue) and apparent life-threatening events (alte): a rand/ucla appropriateness approach
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926945/
https://www.ncbi.nlm.nih.gov/pubmed/33671771
http://dx.doi.org/10.3390/life11020171
work_keys_str_mv AT preziosogiovanni managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT perroneserafina managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT biasuccigiacomo managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT pisigiovanna managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT fainardivalentina managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT strisciugliocaterina managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT marzanofrancescononnis managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT morettisabrina managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT pisanifrancesco managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT tchanabertrand managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT argentieroalberto managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT negliacosimo managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT caffarellicarlo managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT bertolinipatrizia managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT bersinimariateresa managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT canaliandrea managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT vocciaemanuele managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT squarciaantonella managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT ghitullio managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT verrotticarla managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT fruscatiziana managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT cecchirossana managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT giordanogiovanna managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT colasantifilomena managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT rocciailenia managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT palanzapaola managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach
AT espositosusanna managementofinfantswithbriefresolvedunexplainedeventsbrueandapparentlifethreateningeventsaltearanduclaappropriatenessapproach