VITREOUS-HUMOR AND CEREBROSPINAL-FLUID HYPOXANTHINE CONCENTRATION AS A MARKER OF PREMORTEM HYPOXIA IN SIDS

Aims-To assess the rate at which premortem hypoxia occurs in sudden in fant death syndrome (SIDS) when compared with death in early childhood . Methods-The hypoxanthine concentration was measured as a marker of p remortem hypoxia in vitreous humour and cerebrospinal fluid samples ob tained at necropsy from 119 children whose ages ranged from 1 week to 2 years. Results-Increasing interval between death and necropsy was ac companied by an increase in the hypoxanthine concentration of vitreous humour for the first 24 hours, at a rate of 8.3 mumol/l/hour. Thereaf ter, there was little change with time, and the results were corrected to 24 hours according to a regression equation. Cerebrospinal fluid c oncentrations showed no significant change with time following death. Patients were divided into three groups according to the cause of deat h: SIDS, cardiac or pulmonary disease, and others. Median values for t he cerebrospinal fluid hypoxanthine concentrations were not significan tly different among the groups and no difference could be shown betwee n the vitreous humour hypoxanthine concentration in cases of SIDS and those children dying from other causes. Patients with established card iac or pulmonary disease had a significantly reduced vitreous humour h ypoxanthine concentration which may have reflected the premortem use o f artificial ventilation. Conclusions-The results of this study do not support the view that pre-mortem hypoxia is a common feature in SIDS when compared with other causes of death.