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An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
09:01

An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection

Published on: December 10, 2013

Predicting deterioration in previously healthy infants hospitalized with respiratory syncytial virus infection

A M Brooks1, J T McBride, K M McConnochie

  • 1Department of Pediatrics, Children's Hospital at Strong, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. jazbrooks@msn.com

Pediatrics
|September 2, 1999
PubMed

Insights

Clinical deterioration is uncommon in previously healthy infants hospitalized with respiratory syncytial virus (RSV) infection. While extreme tachypnea and hypoxemia predict deterioration, their low sensitivity limits clinical usefulness for early identification.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Respiratory Syncytial Virus (RSV) is a common cause of hospitalization in infants.
  • Clinical deterioration requiring Pediatric Intensive Care Unit (PICU) transfer can occur in previously healthy infants with RSV infection.
  • Identifying infants at risk for deterioration is crucial for timely intervention.

Purpose of the Study:

  • To estimate the incidence of clinical deterioration leading to PICU transfer in previously healthy infants with RSV infection.
  • To assess if initial clinical findings (history, physical exam, oximetry, chest X-ray) can predict such deterioration.

Main Methods:

  • Retrospective analysis of infants aged <=1 year hospitalized with RSV infection (1985-1994).
  • Index patients were previously healthy infants transferred to the PICU; matched with controls not requiring PICU transfer.
  • Comparison of respiratory rate, O2 saturation, wheezing, and chest X-ray findings at presentation.

Main Results:

  • 1.8% of previously healthy infants with RSV infection required PICU transfer.
  • Infants transferred to PICU had modestly abnormal respiratory rates and O2 saturation at presentation.
  • High respiratory rate (>80) and low O2 saturation (<85%) showed high specificity but low sensitivity for predicting deterioration.

Conclusions:

  • PICU admission due to clinical deterioration is infrequent in previously healthy infants with RSV infection on general pediatric units.
  • Extreme tachypnea and hypoxemia are associated with deterioration but have limited predictive value due to low sensitivity.
  • Current clinical parameters have limited usefulness in accurately identifying all infants who will deteriorate.
Abstract

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