A carregar...
Publicação
Implicações da disfunção autonómica no Síndrome de Morte Súbita Infantil
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 483.02 KB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
Apesar do sucesso sem precedentes das campanhas publicitárias para a promoção de práticas de sono seguro do lactente, introduzidas na maioria dos países ocidentais no início da década de 90, a redução da incidência da Síndrome de Morte Súbita Infantil (SMSI) estagnou ao longo dos últimos anos e permanece a principal causa de morte no lactente nos países ocidentais.
Por esse mesmo motivo, tem sido alvo de inúmeros estudos, a maioria dos quais parece apontar no sentido de que, na sua origem, esteja uma disfunção autonómica. Esta seria a responsável pela falha, não só dos mecanismos de controlo cardiorrespiratórios, como também dos mecanismos que desencadeiam a reação de alerta que culmina no despertar do sono e autorresuscitação. Deste modo, a capacidade do lactente de responder apropriadamente a situações ameaçadoras de vida, como a hipotensão ou asfixia prolongadas durante o sono, encontra-se comprometida. Contudo, e apesar de toda a investigação já realizada, os mecanismos fisiopatológicos exatos por detrás da SMSI permanecem ainda por esclarecer.
O reconhecimento das implicações da disfunção autonómica na SMSI permitirá identificar as crianças em risco, promovendo a educação dos pais e cuidadores, bem como a monitorização atenta quer por parte destes, quer dos médicos, privilegiando uma atuação preventiva. Ou, nos casos em que tal não for possível, visando a deteção precoce e, consequentemente, minimizando a incidência e prevalência da SMSI.
Deste modo, esta revisão pretende expor e sistematizar as várias teorias propostas para esclarecimento dos mecanismos de disfunção autonómica implicados na fisiopatologia da SMSI.
Despite the unprecedented success of advertising campaigns intended for promoting safe infant sleep practices, which were introduced in most Western countries in the early 1990s, the reduction in the incidence of Sudden Infant Death Syndrome (SIDS) has stagnated over the past few years and, therefore, remains the leading cause of infant death in Western countries. For that very reason, it has been the subject of numerous studies, most of which seem to point towards an autonomic dysfunction at its origin. This would be responsible for the failure of both the cardiorespiratory control mechanisms and the mechanisms that trigger the alert reaction that culminates in awakening from sleep and self-resuscitation. Consequently, the infant's ability to respond appropriately to life-threatening situations, such as prolonged hypotension or asphyxia during sleep, is compromised. However, despite all the research already carried out, the exact pathophysiological mechanisms behind SIDS remain unclear. Recognizing the implications of autonomic dysfunction in SIDS will make it possible to identify infants at risk, promoting their parents and caregivers`s education and careful monitoring by both them and the doctors, favoring preventive action. Or instead, in cases where this is not possible, aiming at early detection and, consequently, minimizing the incidence and prevalence of SIDS. All things considered, this review aims to expose and systematize the various theories proposed to clarify the mechanisms by which autonomic dysfunction appears to be involved in the pathophysiology of SIDS.
Despite the unprecedented success of advertising campaigns intended for promoting safe infant sleep practices, which were introduced in most Western countries in the early 1990s, the reduction in the incidence of Sudden Infant Death Syndrome (SIDS) has stagnated over the past few years and, therefore, remains the leading cause of infant death in Western countries. For that very reason, it has been the subject of numerous studies, most of which seem to point towards an autonomic dysfunction at its origin. This would be responsible for the failure of both the cardiorespiratory control mechanisms and the mechanisms that trigger the alert reaction that culminates in awakening from sleep and self-resuscitation. Consequently, the infant's ability to respond appropriately to life-threatening situations, such as prolonged hypotension or asphyxia during sleep, is compromised. However, despite all the research already carried out, the exact pathophysiological mechanisms behind SIDS remain unclear. Recognizing the implications of autonomic dysfunction in SIDS will make it possible to identify infants at risk, promoting their parents and caregivers`s education and careful monitoring by both them and the doctors, favoring preventive action. Or instead, in cases where this is not possible, aiming at early detection and, consequently, minimizing the incidence and prevalence of SIDS. All things considered, this review aims to expose and systematize the various theories proposed to clarify the mechanisms by which autonomic dysfunction appears to be involved in the pathophysiology of SIDS.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Síndrome de morte súbita infantil Sistema nervoso autónomo Disfunção autonómica