BRUE: Brief Resolved Unexplained Events

Brief Resolved Unexplained Events (BRUE) represent sudden, alarming, yet resolved episodes in infants under one year old that require precise clinical evaluation. Unlike the older, subjective ALTE classification, BRUE relies on strict criteria involving cyanosis, breathing changes, or altered tone without an identifiable cause. Recent evidence-based models, such as the revised NAMA framework, offer superior risk stratification compared to the 2016 American Academy of Pediatrics guidelines, enabling clinicians to identify low-risk infants who can safely avoid unnecessary diagnostic testing and hospitalization. Management centers on a thorough history and physical examination, as most cases are benign. Clinicians should prioritize parental reassurance, emphasizing that BRUE is not a predictor of SIDS and that routine use of home cardiorespiratory monitors provides no proven benefit, often increasing anxiety and costs without improving clinical outcomes.