In a 2016 clinical practice guideline, the American Academy of Pediatrics (AAP) created and introduced the term brief resolved unexplained event (BRUE). This guideline defined specific criteria for diagnosis of BRUE and provided a set of guidelines for evaluation of these infants as well as characteristics that indicate a BRUE will have a low risk for a repeat event or a serious underlying disorder.
Our recent issue Brief Resolved Unexplained Events: Practical Evaluation and Management in the Emergency Department reviews the definition and broad differential diagnosis of a BRUE, highlights the criteria for risk stratification of infants who experience a BRUE, summarizes the management recommendations for patients with a lower-risk BRUE, and examines the available literature that evaluates the impact of the AAP guidelines in the years since its publication.
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Here are a few key points:
- A brief resolved unexplained event (BRUE) is defined as “an event occurring in an infant <1 year of age when the observer reports a sudden, brief, and now resolved episode of ≥1 of the following: cyanosis or pallor; absent, decreased, or irregular breathing; marked change in tone (hyper- or hypotonia); and altered level of responsiveness.”1
- In addition to the definition of BRUE and other inclusion criteria, factors associated with “lower-risk” patients include:
- Age >60 days
- Gestational age >32 weeks and postconceptional age >45 weeks
- First BRUE (no previous BRUE, not occurring in clusters)
Read the full issue and earn 4 AMA PRA Category 1 Credits™.
