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Necrotizing Enterocolitis Complicating Severe RSV Bronchiolitis in PICU Settings.
Mohammad Sallam1,2, Ryan Breuer1, Brian Wrotniak1
1University at Buffalo, Buffalo, NY, USA.
Clinical Pediatrics
|February 2, 2024
Summary
Necrotizing enterocolitis (NEC) in infants with respiratory syncytial virus (RSV) infection is serious. Critically ill children with RSV require careful monitoring for gastrointestinal symptoms to improve outcomes.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Background:
- Necrotizing enterocolitis (NEC) is a severe gastrointestinal condition in infants.
- Respiratory syncytial virus (RSV) infection can lead to severe illness in young children.
- The interplay between NEC and RSV infection in critically ill pediatric patients is not well understood.
Purpose of the Study:
- To analyze baseline characteristics of pediatric patients with NEC complicating RSV infection.
- To identify factors associated with poor outcomes in this patient population.
- To highlight the importance of gastrointestinal symptom assessment in RSV-infected children.
Main Methods:
- Retrospective study utilizing the Virtual Pediatric Systems data registry.
- Inclusion criteria: patients <2 years old admitted to the pediatric intensive care unit (PICU) with documented RSV infection and NEC or related intestinal issues.
- Analysis of 41 eligible patients.
Main Results:
- Most patients (93%) were between 30 days and 2 years old.
- One-third had congenital heart defects; 20% had a history of prematurity.
- Median PICU length of stay was 11.7 days, with 7 deaths (17%).
- Nonsurvivors showed trends towards higher PRISM-3 scores, acidemia, and lower blood pressure.
Conclusions:
- NEC complicating RSV infection presents unique challenges in critically ill children.
- Baseline cardiac defects and prematurity are common comorbidities.
- Prompt recognition and management of gastrointestinal symptoms are crucial for improving survival rates in RSV-infected infants and children.
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