Sindrom iznenadne dojenačke smrti

master's thesis

• Title (english): Sudden infant death syndrome
• Author: Ana Starešinić
• Mentor: Marija Baković (mentor)
• Committee member: Milovan Kubat (predsjednik povjerenstva)
• Committee member: Davor Mayer (član povjerenstva)
• Committee member: Marija Baković (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Forensic Medicine); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Forensic Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Sindrom iznenadne dojenačke smrti (SIDS), u narodu odavna poznat kao „smrt u kolijevci“, jedna je od najstrašnijih nerazjašnjenih tragedija ljudskog roda. Pojam SIDS vežemo uz situaciju kada se, prethodno naoko zdravo dojenče, nakon stavljanja na spavanje pronađe mrtvo, a nakon opsežne sudskomedicinske obrade koja uključuje pregled mjesta smrti, sudskomedicinsku obdukciju s brojnim dodatnim analizama te pregled zdravstvenog kartona djeteta, i dalje nije moguće razlučiti uzrok smrti. Predloženi su mnogi mehanizmi nastanka poput gušenja/asfiksije u potrbušnom položaju, centralne i/ili obstruktivne apneje, neodgovarajuće razvijen mehanizam odgovora na promjene razine kisika i ugljičnog dioksida (hipoksiju i hiperkarbiju), neadekvatne mehanizme samooživljavanja, te neodgovarajuć odgovor zaštitnih mehanizama na životno ugrožavajuće podražaje iz okoline. SIDS i danas izaziva kontroverze jer je po nekima upitna dijagnoza bez patognomoničnih značajki, dok se s druge strane ponekad nekritički i olako pripisuje svim slučajevima dojenačkih smrti. Dodatno se lome koplja i oko pitanja pripada li SIDS u kategoriju bolesti uzrokovanih jednim uzrokom ili je to sindrom sa zajedničkim značajkama i heterogenim čimbenicima rizika koji imaju aditivni efekt. Upravo zato neki SIDS nazivaju i dijagnoza bez bolesti. Premda sudskomedicinska obrada i dalje ne daje konačne odgovore, dosadašnji pomaci u razumijevanju SIDS-a predstavljaju jedan od velikih uspjeha u zdravstvenoj skrbi dojenčadi.

Abstract (english)

Sudden infant death syndrome (SIDS), also known as “cot death” is one of the most serious, unexplained tregedies of our times. The term “SIDS” is used when a sleeping infant, under the age of one year, who has apparently been healthy, is found unexpectedly dead, and forensic evaluation that consists of scene investigation, forensic autopsy and examination of the medical records of the child, is unable to discern a cause of death. Multiple sleep-related mechanisms have been proposed to cause SIDS. These mechanisms include suffocation/asphyxiation in the face-down sleep position, central and/or obstructive sleep apnea, impaired-state-dependent responses to hypoxia and/ or hypercarbia, inadequate autoresuscitation, defective autonomic regulation of blood pressure or thermal responses, and abnormal arousal to life-threatening challenges during sleep. It has been a somewhat controversial term that on one hand has been criticized for not being a proper diagnosis with pathognomonic features, contrasting on the other hand with situations where it has been uncritically and inconsistently applied to all manner of infant deaths. It has been argued that SIDS constitutes a disease with a single cause, an argument which is at odds with those who feel that it is instead a syndrome with common features, and probable heterogeneous and additive risk factors. For this reason it has been called a “diagnosis without a disease”. Despite the shortcomings of forensic medicine, the SIDS story over the past several decades has been one of the great successes in infant healthcare.

• Keywords: SIDS; dojenče; apneja; potrbušni položaj; spavanje
• Keywords (english): SIDS; infant; apnea; prone position; sleeping
• Language: croatian
• URN:NBN: urn:nbn:hr:105:670172
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-02-25 08:29:39