SHAKEN BABY SYNDROME – 10 YEARS EXPERIENCE IN A PAEDIATRIC INTENSIVE CARE SERVICE

Abstract

Introduction: Shaken baby syndrome is one of the causes of non-accidental injury most difficult to diagnose.

Objectives: To characterize the patients hospitalized in the intensive care unit with shaken baby syndrome.

Material and Methods: Retrospective study of patients admitted at the Paediatric Intensive Care Unit with shaken baby syndrome from 1 January 1999 to 31 December 2009.

Results: There were eight children with shaken baby syndrome. The mean age was 4.1 months and five patients were male. One patient had a history of trauma. The most frequent cause of admission were epileptic seizures with cardiorespiratory/ respiratory arrest (50%). Bilateral retinal haemorrhages were present in six patients (75%). The CT scan showed subdural haematomas in all patients. Seven patients (87.5%) required mechanical ventilation, and five (62.5%) required inotropic support. The mean length of hospitalization was 5.25 days (1 -11 days). One patient died. Three patients showed no sequelae. There was a transient hemiparesis in one patient. Three patients presented epilepsy and deficits in visual acuity or hearing and in one case there was loss of prior acquisitions with a moderate to severe retardation of psychomotor development.

Conclusion: In our study Shaken Baby Syndrome resulted in high morbidity with long-term sequelae in five patients (62,5%), consistent with data published in other series. The mortality rate was lower than in previous studies (12.5%). The presence of traumatic history was mentioned only in one case and, although all of them presented subdural haematomas, 25% of cases had no retinal haemorrhages. The clinical presentation was very severe and in most cases a high degree of suspicion is necessary in the diagnosis.