Human Rhinovirus/Enterovirus in Pediatric Acute Respiratory Distress Syndrome

Area of Science:

• Pediatric critical care medicine
• Virology
• Respiratory medicine

Background:

• The role of human rhinovirus/enterovirus (HRV/HEV) in severe lower respiratory tract infections is not fully understood.
• HRV/HEV are common viruses, but their impact on critically ill children requires further characterization.

Purpose of the Study:

• To characterize the respiratory status of children with confirmed HRV/HEV infection admitted to a pediatric intensive care unit (PICU).
• To assess the severity of respiratory illness associated with HRV/HEV in this pediatric population.

Main Methods:

• Retrospective chart review of 155 children admitted to a PICU with confirmed HRV/HEV infection.
• Analysis of respiratory support requirements, including positive pressure ventilation.
• Assessment of oxygenation using SaO2 to FiO2 ratios and identification of pediatric acute respiratory distress syndrome (PARDS) criteria.

Main Results:

• 62% of children required positive pressure respiratory support (≥5 cm H2O) within 24 hours of admission.
• 34% had SaO2 to FiO2 ratios ≤264, indicating significant hypoxemia.
• 14% (22 patients) met the criteria for pediatric acute respiratory distress syndrome.

Conclusions:

• Human rhinovirus/enterovirus (HRV/HEV) is associated with significant respiratory morbidity in children admitted to the PICU.
• HRV/HEV infection can lead to severe respiratory compromise, including the need for mechanical ventilation and the development of PARDS.
• These findings underscore the importance of considering HRV/HEV in the differential diagnosis of severe pediatric respiratory illness.