TY - CHAP M1 - Book, Section TI - Brief Resolved Unexplained Events A1 - Rhine, Jonathan A1 - Sapien, Robert A1 - Tieder, Joel S. A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. A2 - Schafermeyer, Robert Y1 - 2019 N1 - T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 5e AB - A brief resolved unexplained event (BRUE) is defined as “an event occurring in an infant younger than 1 year when the observer reports a sudden, brief, and now resolved episode of ≥1 of the following: (1) cyanosis or pallor; (2) absent, decreased, or irregular breathing; (3) marked change in tone (hyper- or hypotonia); and (4) altered level of responsiveness,” and a thorough history and physical examination which fails to identify an explanation.1,2BRUE is a more specific term intended to replace ALTE (apparent life-threatening event)BRUE is cohorted into lower- and higher-risk groups. Criteria for lower-risk include (1) age >60 days, (2) gestational age ≥32 weeks and postconceptional age ≥45 weeks, (3) a single episode with no previous BRUEs, (4) duration of BRUE <1 minute, (5) no cardiopulmonary resuscitation by trained medical personnel required, (6) no concerning historical features, and (7) no concerning physical examination findings.Lower-risk BRUE infants generally do not require clinical investigations and can be discharged home from the emergency department (ED).Most higher-risk patients, particularly those under 2 months of age, typically benefit from hospitalization for further monitoring for recurrent events, diagnostic evaluation, or treatment. In some cases, close outpatient follow-up may be reasonable.BRUE is a diagnosis of exclusion just like another acute idiopathic condition of infancy, the febrile seizure. Both have lower- and higher-risk categories. The lower-risk groups of both of these conditions require few if any investigations and can be discharged from the ED. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1155167348 ER -