Initial treatment in the emergency department involves continued resuscitation of the infant, if necessary, and stabilization. In general, all ALTE victims and infants with a history of apnea and/or cyanosis should be admitted to the hospital. The evaluation of these infants is designed to rule out treatable causes of apnea and to determine whether, in the absence of these other causes, the infant is at risk for SIDS, an event reported in from 20 to 100 percent of infants with an ALTE.
Apnea should be monitored in the hospital. Most hospitals are able to obtain pneumograms, which provide evidence of abnormalities related to periodic breathing or episodes of apnea. Polysomnography measures the amount of air flowing in at the mouth and nose and can detect obstructive apnea; the test is complicated and is generally done in a sleep laboratory. Certain tertiary care centers are equipped to evaluate responses to CO 2 breathing and diminished inspiratory oxygen.
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