Pediatric intensive care unit admission due to respiratory syncytial virus: Retrospective multicenter study

Ji Man Kang, Jina Lee, Yun Kyung Kim, Hye Kyung Cho, Su Eun Park, Kyung Hyo Kim, Min Ji Kim, Seonwoo Kim, Yae Jean Kim

Research output: Contribution to journalArticle

Abstract

Background: We investigated the characteristics and clinical outcomes of respiratory syncytial virus (RSV)-related pediatric intensive care unit (PICU) hospitalization and assessed the palivizumab (PZ) prophylaxis eligibility according to different guidelines from Korea, EU, and USA. Methods: In this multicenter study, children <18 years of age hospitalized in six PICU from different hospitals due to severe RSV infection between September 2008 and March 2013 were included. A retrospective chart review was performed. Results: A total of 92 patients were identified. The median length of PICU stay was 6 days (range, 1–154 days) and median PICU care cost was USD2,741 (range, USD556–98 243). Of 62 patients who were <2 years old at the beginning of the RSV season, 33 (53.2%) were high-risk patients for severe RSV infection. Hemodynamically significant congenital heart disease (22.6%) was the most common risk factor, followed by chronic lung disease (11.3%), neuromuscular disease or congenital abnormality of the airway (NMD/CAA) (11.3%), and prematurity (8.1%). The percentage of patients eligible for PZ prophylaxis ranged from 38.7% to 48.4% based on the guidelines, but only two (2.2%) received PZ ≤30 days prior to PICU admission. The median duration of mechanical ventilation was longer in children with NDM/CAA than in those without risk factors (26 days; range, 24–139 days vs 6 days, range, 2–68 days, P = 0.033). RSV-attributable mortality was 5.4%. Conclusions: Children <2 years old with already well-known high risks represent a significant proportion of RSV-related PICU admissions. Increasing of the compliance for PZ prophylaxis practice among physicians is needed. Further studies are needed to investigate the burden of RSV infection in patients hospitalized in PICU, including children with NMD/CAA.

Original languageEnglish
Pages (from-to)688-696
Number of pages9
JournalPediatrics International
Volume61
Issue number7
DOIs
Publication statusPublished - 2019 Jul 1

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Pediatric Intensive Care Units
Respiratory Syncytial Viruses
Multicenter Studies
Retrospective Studies
Respiratory Syncytial Virus Infections
Neuromuscular Diseases
Guidelines
Korea
Artificial Respiration
Lung Diseases
Compliance
Heart Diseases
Hospitalization
Chronic Disease
Physicians
Costs and Cost Analysis
Mortality
Palivizumab

Keywords

  • eligibility
  • guideline
  • neuromuscular disorder or congenital abnormality of the airway
  • pediatric intensive care unit
  • respiratory syncytial virus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Pediatric intensive care unit admission due to respiratory syncytial virus : Retrospective multicenter study. / Kang, Ji Man; Lee, Jina; Kim, Yun Kyung; Cho, Hye Kyung; Park, Su Eun; Kim, Kyung Hyo; Kim, Min Ji; Kim, Seonwoo; Kim, Yae Jean.

In: Pediatrics International, Vol. 61, No. 7, 01.07.2019, p. 688-696.

Research output: Contribution to journalArticle

Kang, Ji Man ; Lee, Jina ; Kim, Yun Kyung ; Cho, Hye Kyung ; Park, Su Eun ; Kim, Kyung Hyo ; Kim, Min Ji ; Kim, Seonwoo ; Kim, Yae Jean. / Pediatric intensive care unit admission due to respiratory syncytial virus : Retrospective multicenter study. In: Pediatrics International. 2019 ; Vol. 61, No. 7. pp. 688-696.
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abstract = "Background: We investigated the characteristics and clinical outcomes of respiratory syncytial virus (RSV)-related pediatric intensive care unit (PICU) hospitalization and assessed the palivizumab (PZ) prophylaxis eligibility according to different guidelines from Korea, EU, and USA. Methods: In this multicenter study, children <18 years of age hospitalized in six PICU from different hospitals due to severe RSV infection between September 2008 and March 2013 were included. A retrospective chart review was performed. Results: A total of 92 patients were identified. The median length of PICU stay was 6 days (range, 1–154 days) and median PICU care cost was USD2,741 (range, USD556–98 243). Of 62 patients who were <2 years old at the beginning of the RSV season, 33 (53.2{\%}) were high-risk patients for severe RSV infection. Hemodynamically significant congenital heart disease (22.6{\%}) was the most common risk factor, followed by chronic lung disease (11.3{\%}), neuromuscular disease or congenital abnormality of the airway (NMD/CAA) (11.3{\%}), and prematurity (8.1{\%}). The percentage of patients eligible for PZ prophylaxis ranged from 38.7{\%} to 48.4{\%} based on the guidelines, but only two (2.2{\%}) received PZ ≤30 days prior to PICU admission. The median duration of mechanical ventilation was longer in children with NDM/CAA than in those without risk factors (26 days; range, 24–139 days vs 6 days, range, 2–68 days, P = 0.033). RSV-attributable mortality was 5.4{\%}. Conclusions: Children <2 years old with already well-known high risks represent a significant proportion of RSV-related PICU admissions. Increasing of the compliance for PZ prophylaxis practice among physicians is needed. Further studies are needed to investigate the burden of RSV infection in patients hospitalized in PICU, including children with NMD/CAA.",
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