Respiracinio sincitinio viruso infekcijos aktualumas vaikų kardiochirurgijoje

Solveiga Umbrasaitė, Kęstutis VersockasVilniaus universiteto ligoninės Santariškių klinikos, Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Įvadas / tikslas Respiracinis sincitinis virusas (RSV) yra dažniausia apatinių kvėpavimo takų infekcijos priežastis, ypač naujagimiams ir kūdikiams. Tarp vaikų, kuriems yra padidėjusi sunkios RSV infekcijos formos rizika, yra turinčių įgimtą širdies ydą. Ši rizika yra dar didesnė atliekant širdies operacijas. Šio tyrimo tikslas buvo išsiaiškinti, kiek yra infekuotų RSV vaikų tarp patenkančių į stacionarą operaciniam gydymui. Metodai ir rezultatai Specifiniai RSV imunoglobulinų testai buvo atlikti 32 vaikų grupėje (iš kurių 9 naujagimiai ir 23 kūdikiai). Teigiamų IgG antikūnų rasta 12 atvejų (41%), teigiamų IgM antikūnų – vienu. Išvados RSV infekuotų vaikų yra gana daug; dėl to tikslinga tęsti tyrimus. Kitas žingsnis būtų išsiaiškinti RSV infekcijos įtaką perioperacinei pacientų būklei ir pasyvios imunoprofilaktikos palivizumabu tikslingumą. Pagrindiniai žodžiai: respiracinis sincitinis virusas, įgimtos širdies ydos, imunoprofilaktika Relevance of RSV infection in children’s cardiac surgery Solveiga Umbrasaitė, Kęstutis VersockasVilnius University Hospital „Santariškių klinikos“, Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Background / objective Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infections, especially in newborns and children under one year of age. Among children at a higher risk of a severe form of RSV infection are children with congenital heart disease. This risk is higher in case of heart operation.The purpose of this research was to reveal the incidence of RSV-infected patients among those admitted for surgical treatment. Methods and results Specific RSV immunoglobulin tests were performed for a group of 32 children (9 newborns and 23 infants). Positive IgG antibodies were found in 12 cases (41%) and positive IgM antibodies in one case. Conclusions The incidence of RSV-infected children is quite high; therefore, it is purposeful to continue research. The next step would be to reveal the influence of RSV infection on the perioperative condition of patients and the expediency of passive imunoprophylaxis with palivizumab. Key words: respiratory syncytial virus, congenital heart disease, imunoprophylaxis

Download Full-text

Managing the Morbidity Associated with Respiratory Viral Infections in Children with Congenital Heart Disease

International Journal of Pediatrics ◽

10.1155/2012/646780 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 11

Author(s):

Joseph M. Geskey ◽

Stephen E. Cyran

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Acute Treatment ◽

Congenital Heart ◽

Viral Infections ◽

Effective Vaccine ◽

Cardiac Complications ◽

Rsv Infection ◽

Syncytial Virus ◽

Tract Infections

Children with congenital heart disease (CHD) are at risk for increased morbidity from viral lower respiratory tract infections because of anatomical cardiac lesions than can worsen an already compromised respiratory status. Respiratory syncytial virus (RSV) remains an important pathogen in contributing toward the morbidity in this population. Although the acute treatment of RSV largely remains supportive, the development of monoclonal antibodies, such as palivuzumab, has reduced the RSV-related hospitalization rate in children with CHD. This review highlights the specific cardiac complications of RSV infection, the acute treatment of bronchiolitis in patients with CHD, and the search for new therapies against RSV, including an effective vaccine, because of the high cost associated with immunoprophylaxis and its lack of reducing RSV-related mortality.

Download Full-text

Palivizumab compliance in congenital heart disease patients: factors related to compliance and altered lower respiratory tract infection viruses after palivizumab prophylaxis

Cardiology in the Young ◽

10.1017/s1047951120001092 ◽

2020 ◽

Vol 30 (6) ◽

pp. 818-821

Author(s):

Kutay Sel ◽

Ebru Aypar ◽

Yasemin Nuran Dönmez ◽

Emil Aliyev ◽

Hakan Hayrettin Aykan ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Respiratory Syncytial Virus ◽

Respiratory Tract ◽

Lower Respiratory Tract ◽

Congenital Heart ◽

Respiratory Tract Infections ◽

Lower Respiratory Tract Infections ◽

Syncytial Virus ◽

Tract Infections

AbstractBackground:Lower respiratory tract infections caused by respiratory syncytial virus can be severe during infancy, which requires admission to the hospital. These infections may be more severe especially in patients with congenital heart disease. Passive immunisation with palivizumab, a monoclonal antibody, is recommended in high-risk infants. We tried to determine the compliance rates, factors affecting compliance, and also other microorganisms responsible for lower respiratory tract infections after palivizumab prophylaxis in these patients.Methods:We evaluated patients’ compliance to prophylaxis with palivizumab in two consecutive respiratory syncytial virus seasons from pharmacy records. We also investigated factors affecting compliance and the frequency of hospitalisations for lower respiratory tract infections. We investigated the causative microorganisms detected in hospitalised patients.Results:In this study, 86.7% of the desired number of injections was achieved in 176 patients in two seasons. Out of these, 117 patients (66.4%) received all the doses they were prescribed. Although not statistically significant, compliance to prophylaxis was higher in male patients, cyanotic patients, those who started under 1 year old, and who lived in the city centre. Human metapneumovirus, parainfluenza type 3, and bocavirus were detected in the hospitalised patients.Conclusion:Patients with congenital heart disease can survive the period of infancy with less problem by making palivizumab prophylaxis more effective, and awareness about non- respiratory syncytial virus factors may be a guide for the development of new treatments.

Download Full-text

Palivizumab prophylaxis against respiratory syncytial virus infection in patients younger than 2 years of age with congenital heart disease

Annals of Saudi Medicine ◽

10.5144/0256-4947.2021.31 ◽

2021 ◽

Vol 41 (1) ◽

pp. 31-35

Author(s):

Mohammed Hassan A. Mohammed ◽

Rihab Agouba ◽

Islam El Obaidy ◽

Fahad Alhabshan ◽

Riyadh Abu-Sulaiman

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Respiratory Syncytial Virus ◽

Hospital Admission ◽

Congenital Heart ◽

Hospital Admissions ◽

Compliance Rate ◽

Viral Pathogen ◽

Rsv Infection ◽

Syncytial Virus

BACKGROUND: Respiratory syncytial virus (RSV) is a viral pathogen that causes annual epidemics of lower respiratory tract infection with substantial morbidity and mortality in young children, especially those with congenital heart disease (CHD). Palivizumab is the only immunoprophylaxis therapy approved for RSV infection in infants with hemodynamically significant acyanotic or cyanotic CHD. OBJECTIVE: Identify the compliance rate with vaccination and study the effect of RSV vaccination on hospital admissions. DESIGN: Retrospective descriptive study. SETTING: Cardiac center. PATIENTS AND METHODS: Patient data was obtained from outpatient clinic records, inpatient records, and a surgical database for the period from October 2010 to March 2016. Infants with hemodynamically significant CHD, cyanotic CHD and moderate-to-severe pulmonary hypertension were included in the study. Palivizumab 15/mg/kg was given monthly starting from October, the usual beginning of the epidemic season, with five doses in the first season and six doses in the remaining season scheduled for administration. Patients were interviewed at every clinic visit for any side effects during the previous month, occurrence of any RSV infection and any hospital admission. Selection criteria included RSV vaccination and absence of RSV disease. Patients were excluded if they had RSV infection or a repaired cardiac lesion. MAIN OUTCOME MEASURES: Compliance rate, hospital admission frequency and period of stay. SAMPLE SIZE: 530 during six seasons of RSV epidemics. RESULTS: Fourteen patients (2.6%) developed RSV infection and 13 (2.5%) required hospital admission, but only one patient (0.1%) needed intensive care admission. There were no deaths related to RSV infection; however 11 patients died due to causes unrelated to RSV infection. The average compliance rate was 97%. CONCLUSION: Palivizumab was well tolerated and effective in the prophylaxis of severe RSV infection in children with CHD. As in other studies of palivizumab prophylaxis, we observed a reduction in hospital admissions. LIMITATIONS: Retrospective design. CONFLICT OF INTEREST: None.

Download Full-text

Behcet Uz Cocuk Hast Derg. 2021; 11(2): 174-180 | DOI: 10.5222/buchd.2021.60320 Does Prophylaxis Against Respiratory Syncytial Virus Infection Affect the Weight Percentiles of Infants with Hemodynamically Significant Congenital Heart Disease?

Journal of Dr Behcet Uz Children s Hospital ◽

10.5222/buchd.2021.60320 ◽

2021 ◽

Author(s):

Ali Orgun ◽

İbrahim İlker Çetin ◽

Hazım Alper Gürsu

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Respiratory Syncytial Virus ◽

Congenital Heart ◽

Humanized Monoclonal Antibody ◽

Number Of Patients ◽

Significant Difference ◽

Rsv Infection ◽

Syncytial Virus ◽

Weight Percentile

Objective: The risk of severe respiratory syncytial virus (RSV) infection with significant morbidity and mortality is greatest in patients with hemodynamically significant congenital heart disease (hs-CHD). The humanized monoclonal antibody, palivizumab, was used as prophylaxis for RSV infection in children <24 months of age suffering from hs-CHD. We performed this study to evaluate the effects of RSV prophylaxis with palivizumab on the weight percentiles of infants with hs-CHD. Methods: During the RSV seasons between 2013 and 2017, children <24 months of age with hs-CHD who received ≥3 doses of palivizumab prophylaxis were included in this study. All patients were evaluated according to their weight percentiles examined at birth, at the first, and the last dose of palivizumab prophylaxis. The third percentile was accepted as the cut-off value of the lower weight percentile, and values below the 25th percentile were accepted as poorly controlled hs-CHD. Results: Sixty-one infants aged between 10 days and 15 months were included in the study. The infants received the first dose of palivizumab at the age of 5 months, and all infants received 4.56±0.78 injections on an average. The number of patients weighing lower than the 25th percentile at the first, and the last dose of palivizumab were 36 (59 %) and 29 (47.5 %), respectively. A statistically significant difference was found between weight percentiles of infants at the first and the last dose of palivizumab (p<0.05). Discussion and conclusion: RSV prophylaxis with palivizumab affects weight percentiles positively, and it may help to reduce the hospitalization rate due to RSV infections in infants with hs-CHD.

Download Full-text