A CONTRIBUTION TO A POSSIBLE DIFFERENTIATION BETWEEN SIDS AND ASPHYXIATION

The singular and combined appearance of conjunctival petechiae, of acu te pulmonary emphysema and of signs of aspiration was evaluated in res uscitated and non-resuscitated children dying of SIDS (n = 115), of ot her causes of natural death (n = 17), of severe head injury (n = 10) a nd of asphyxiation/strangulation (n = 7). Conjunctival petechiae occur red in all of the asphyxiated victims and in five out of 10 children d ying of severe head injury, but were exclusively found in four resusci tated babies and one baby with questionable resuscitation trials of th e SIDS-group (4%), furthermore in one resuscitated child dying of a co ngenital heart defect. Acute pulmonary emphysema was detected in six o ut of the seven children of the asphyxiation/strangulation group, in t wo resuscitated children with head injury and in five resuscitated bab ies dying of SIDS. Both parameters were observed exclusively in the as phyxiation/strangulation group (71% of the cases) but not in the contr ol cases. Therefore, it can be concluded that the simultaneous appeara nce of conjunctival petechiae and of acute pulmonary emphysema strongl y indicates death by asphyxiation, (C) 1998 Elsevier Science Ireland L td.