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James M. Lewis, MD; Dorothy J. Ganick, MD

Am J Dis Child. 1986;140(5):484-486.

Abstract
• We reviewed the cases of 201 infants hospitalized for "presumed near-miss" sudden infant death syndrome over a recent five-year period to determine the value of routine initial laboratory investigations in establishing diagnosis or altering therapy. A total of 1,278 measurements were performed on 163 patients aged 3 days to 6 months; 276 (22%) of the results were outside the normal limits for age. The most common abnormalities were hyperchloremia (58% of infants tested), hypermagnesemia (43%), hypobicarbonatemia (33%), and hyperkalemia (27%). There were no instances of polycythemia, hypochloremia, hypokalemia, hyperbicarbonatemia, or uremia. Only six (0.5%) of the abnormal values in four patients were useful in diagnosing or treating the apneic episodes. Infants with respiratory symptoms at the time of presentation had a statistically greater incidence of abnormal values than patients who were asymptomatic. Because of the low yield of useful information, we conclude that the use of a routine battery of laboratory investigations in the initial evaluation of infants with presumed near-miss sudden infant death syndrome should be questioned.

(AJDC 1986;140:484-486)

Author Affiliations
From the Departments of Pediatrics, University of Maryland School of Medicine, Baltimore (Dr Lewis), and Marshall University School of Medicine, Huntington, WVa (Dr Ganick). Dr Lewis is now with the Department of Pediatrics, Marshall University School of Medicine.

Footnotes
Accepted for publication Feb 4, 1986.

Reprint requests to Department of Pediatrics, Marshall University School of Medicine, 1801 Sixth Ave, Huntington, WV 25701 (Dr Lewis).

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