Respiratory syncytial virus infections in the pediatric intensive care unit

Clinical characteristics and risk factors for adverse outcomes

Steven C. Buckingham, Michael W. Quasney, Andrew J. Bush, John Devincenzo

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Objectives:To describe the clinical characteristics of infants admitted to a pediatric intensive care unit (PICU) with respiratory syncytial virus (RSV) infection, including the prevalence of indications for RSV passive antibody prophylaxis (as currently recommended by the American Academy of Pediatrics), and to identify risk factors that predict adverse outcomes among this population. Design:Retrospective medical record review. Setting:Tertiary care PICU. Patients:Children <2 yrs of age admitted to PICU for the management of RSV disease during the 1994-95, 1995-96, and 1996-97 RSV seasons. Measurements and Main Results:The medical records of 89 infants were reviewed. Of these, 55% were born before 36-wks gestation, 14% had chronic lung disease that required medical therapy within the previous 6 months, and 30% met at least one indication for RSV passive antibody prophylaxis. Seven infants had congenital heart disease, five had upper airway abnormalities, and six had various noncardiac congenital malformations. Logistic regression was used to determine which characteristics were associated with prolonged durations (>75th percentile) of mechanical ventilation, PICU stay, and hospital stay. Prolonged mechanical ventilation was associated with congenital heart disease (p 0.014), chronic lung disease (p 0.007), and noncardiac congenital malformations (p 0.022). Only congenital heart disease was associated with prolonged PICU stay (p 0.004) or prolonged hospital stay (p 0.006). All of the infants with airway abnormalities had prolonged ventilator days, PICU days, and hospital days. Currently recommended indications for RSV passive antibody prophylaxis were not predictive of prolonged ventilation, PICU stay, or hospital stay. Conclusions:A minority of infants admitted to our PICU for severe RSV disease meet currently recommended indications for RSV passive antibody prophylaxis. Risk factors that predict prolonged durations of ventilation, PICU stay, or hospital stay among this population include congenital heart disease, chronic lung disease, upper airway abnormalities, and noncardiac congenital malformations.

Original languageEnglish (US)
Pages (from-to)318-323
Number of pages6
JournalPediatric Critical Care Medicine
Volume2
Issue number4
DOIs
StatePublished - Jan 1 2001

Fingerprint

Respiratory Syncytial Virus Infections
Pediatric Intensive Care Units
Respiratory Syncytial Viruses
Length of Stay
Heart Diseases
Artificial Respiration
Lung Diseases
Ventilation
Antibodies
Chronic Disease
Virus Diseases
Tertiary Healthcare
Mechanical Ventilators
Population
Medical Records
Pediatrics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Respiratory syncytial virus infections in the pediatric intensive care unit : Clinical characteristics and risk factors for adverse outcomes. / Buckingham, Steven C.; Quasney, Michael W.; Bush, Andrew J.; Devincenzo, John.

In: Pediatric Critical Care Medicine, Vol. 2, No. 4, 01.01.2001, p. 318-323.

Research output: Contribution to journalArticle

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