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See below
 
----- Original Message -----=20
From: Dr. Nikolaus Lutz-Dettinger <[log in to unmask]>
Subject: SIDS-diagnostik protocol
 
 
> Dear colleagues,
>=20
> we are in the process of rewriting our SIDS-protocol and would be
> interested in the diagnostic work-up, which you do. Besides of being
> interested in your protocol in general, I would like to know
> (concerning the child who is declared dead on arrival):
> 1) Do you do any chemistry? Which? On blood? On other fluids?
=20
No. I do send a blood culture though. During RSV season, I may send off =
an RSV antigen from the ETT aspirate.  =20
 
>=20
2) Anybody who takes vitreous humour? For which determinations?
=20
No
 
> 3) How informative are any of these investigations in your own
> experience?
=20
Have had 1 case of post mortem "meningococcemia."
 
> 4) Is funduscopy routinely done? Does it change early after death?
=20
Yes I always do it.... to look for retinal hemmorhages.
 
>
 5) Do you do a CT of the head in every case?
=20
No
>
 6) Besides of the Xray's of the skeleton, do you do other imaging? Do =
you
> find an Xray of the thorax informative? Which postmortem-changes have
> to be taken into account with the Xray of the thorax?
=20
Yes, I routinely do a "Babygram" radiograph. Again, primarily looking =
for evidence of Battered Child Syndrome. Anterior rib fractures may be a =
result of aggressive CPR, however, posterior ones make me suspicious for =
BCS. Also, a dilated heart is not uncommon following an acute hypoxic =
ischemic insult.  =20
>=20
> I'll be very grateful for any answer; additional references would be
> much appreciated of course.
>=20
> Thanks,
>=20
> Jay Pershad, MD
(pem-pal)
 
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<DIV><FONT face=3DArial size=3D2>See below</FONT></DIV>
<DIV>&nbsp;</DIV>
<DIV><FONT face=3DArial size=3D2>----- Original Message ----- </FONT>
<DIV><FONT face=3DArial size=3D2>From: Dr. Nikolaus Lutz-Dettinger =
&lt;<A=20
href=3D"mailto:[log in to unmask]">[log in to unmask]</A>&gt;</=
FONT></DIV>
<DIV><FONT face=3DArial size=3D2>Subject: SIDS-diagnostik=20
protocol</FONT></DIV></DIV>
<DIV><BR></DIV>
<DIV><FONT face=3DArial size=3D2>&gt; Dear colleagues,<BR>&gt; <BR>&gt; =
we are in=20
the process of rewriting our SIDS-protocol and would be<BR>&gt; =
interested in=20
the diagnostic work-up, which you do. Besides of being<BR>&gt; =
interested in=20
your protocol in general, I would like to know<BR>&gt; (concerning the =
child who=20
is declared dead on arrival):<BR>&gt; 1) Do you do any chemistry? Which? =
On=20
blood? On other fluids?</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT>&nbsp;</DIV>
<DIV><FONT face=3DArial size=3D2><EM>No. I do send a blood culture=20
though.&nbsp;During RSV season,&nbsp;I may send off an RSV antigen from =
the ETT=20
aspirate.&nbsp;&nbsp; <BR></EM></FONT></DIV>
<DIV><FONT face=3DArial size=3D2>&gt; </FONT></DIV>
<DIV><FONT face=3DArial size=3D2>2) Anybody who takes vitreous humour? =
For which=20
determinations?</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT>&nbsp;</DIV>
<DIV><FONT face=3DArial size=3D2><EM>No<BR></EM></FONT></DIV>
<DIV><FONT face=3DArial size=3D2>&gt; 3) How informative are any of =
these=20
investigations in your own<BR>&gt; experience?</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT>&nbsp;</DIV>
<DIV><EM><FONT face=3DArial size=3D2>Have had 1 case of post mortem=20
"meningococcemia."</FONT></EM></DIV>
<DIV><BR><FONT face=3DArial size=3D2>&gt; 4) Is funduscopy routinely =
done? Does it=20
change early after death?</FONT></DIV>
<DIV><FONT face=3DArial size=3D2></FONT>&nbsp;</DIV>
<DIV><FONT face=3DArial size=3D2><EM>Yes I always do it.... to&nbsp;look =
for retinal=20
hemmorhages</EM>.<BR></FONT></DIV>
<DIV><FONT face=3DArial size=3D2>&gt;</FONT></DIV>
<DIV><FONT face=3DArial size=3D2>&nbsp;5) Do you do a CT of the head in =
every=20
case?</FONT></DIV>
<DIV><FONT face=3DArial size=3D2><EM></EM></FONT>&nbsp;</DIV>
<DIV><FONT face=3DArial size=3D2><EM>No</EM></FONT></DIV>
<DIV><FONT face=3DArial size=3D2>&gt;</FONT></DIV>
<DIV><FONT face=3DArial size=3D2>&nbsp;6) Besides of the Xray's of the =
skeleton, do=20
you do other imaging? Do you<BR>&gt; find an Xray of the thorax =
informative?=20
Which postmortem-changes have<BR>&gt; to be taken into account with the =
Xray of=20
the thorax?</FONT></DIV>
<DIV><FONT size=3D2><FONT =
face=3DArial><EM></EM></FONT></FONT>&nbsp;</DIV>
<DIV><FONT size=3D2><FONT face=3DArial><EM>Yes, I routinely do a =
"Babygram"=20
radiograph. Again, primarily looking for evidence of Battered Child=20
Syndrome.&nbsp;Anterior rib fractures&nbsp;may be a result of aggressive =
CPR,=20
however, posterior ones make me suspicious for BCS. Also, a dilated =
heart is not=20
uncommon following an acute hypoxic ischemic insult. &nbsp; =
<BR></EM>&gt;=20
<BR>&gt; I'll be very grateful for any answer; additional references =
would=20
be<BR>&gt; much appreciated of course.<BR>&gt; <BR>&gt; Thanks,<BR>&gt; =
<BR>&gt;=20
<FONT face=3DArial size=3D2>Jay Pershad,=20
MD<BR>(pem-pal)</FONT></FONT></FONT></DIV></BODY></HTML>
 
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