PEDIATRICS Vol. 87 No. 2 February 1991, pp. 190-198
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Sudden Infant Death Syndrome and Small Airway Occlusion: Facts and a Hypothesis

Fernando D. Martinez MD1

1 From the Department of Pediatrics, Children's Research Center, and the Division of Respiratory Sciences, University of Arizona College of Medicine, Tucson

Respiratory failure is almost certainly the cause of death in the majority of cases of sudden infant death syndrome (SIDS), but the mechanisms leading to it have not been elucidated. SIDS shares many environmental and socioeconomic risk factors with severe forms of bronchiolitis, and the age distribution of incident cases is similar. Present knowledge of lung and airway development during infancy, determinants of peripheral airway patency, changes in lung surface activity in infants with SIDS, and fluid film dynamics in small airways are reviewed. It is hypothesized that many cases of SIDS may be due to a final episode of progressive peripheral bronchial occlusion in infants with preceding critically diminished conductance of the smaller airways.

Key Words: sudden infant death syndrome • bronchial obstruction • airway closure • apnea

Submitted on October 16, 1989
Accepted on January 22, 1990




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