scholarly journals The Association between Weather Conditions and Admissions to the Paediatric Intensive Care Unit for Respiratory Syncytial Virus Bronchiolitis

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 567
Author(s):  
Rosalie Linssen ◽  
Bibiche den Hollander ◽  
Louis Bont ◽  
Job van Woensel ◽  
Reinout Bem ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Syncytial Virus ◽  
The Netherlands ◽  
Global Radiation ◽  
Weather Conditions ◽  
Paediatric Intensive Care ◽  
Maximum Temperature ◽  
Weather Variables ◽  
Syncytial Virus ◽  
Over Time

Respiratory syncytial virus (RSV) bronchiolitis is a leading cause of global child morbidity and mortality. Every year, seasonal RSV outbreaks put high pressure on paediatric intensive care units (PICUs) worldwide, including in the Netherlands, and this burden appears to be increasing. Weather conditions have a strong influence on RSV activity, and climate change has been proposed as a potential important determinant of future RSV-related health care utilisation. In this national study spanning a total of 13 years with 2161 PICU admissions for RSV bronchiolitis, we aimed (1) to identify meteorological variables that were associated with the number of PICU admissions for RSV bronchiolitis in the Netherlands and (2) to determine if longitudinal changes in these variables occurred over time as a possible explanation for the observed increase in PICU burden. Poisson regression modelling was used to identify weather variables (aggregated in months and weeks) that predicted PICU admissions, and linear regression analysis was used to assess changes in the weather over time. Maximum temperature and global radiation best predicted PICU admissions, with global radiation showing the most stable strength of effect in both month and week data. However, we did not observe a significant change in these weather variables over the 13-year time period. Based on our study, we could not identify changing weather conditions as a potential contributing factor to the increased RSV-related PICU burden in the Netherlands.

The potential impact of prophylaxis against bronchiolitis due to the respiratory syncytial virus in children with congenital cardiac malformations

2005 ◽  
Vol 15 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Oliver J. Rackham ◽  
Kentigern Thorburn ◽  
Steve J. Kerr
Keyword(s):  
Intensive Care ◽  
Respiratory Syncytial Virus ◽  
High Risk ◽  
Paediatric Intensive Care ◽  
Economic Management ◽  
Cardiology Department ◽  
Number Of Patients ◽  
Potential Impact ◽  
Syncytial Virus ◽  
Alder Hey

Aims:To determine the number of infants in the Mersey and North West regions with congenital cardiac disease for whom palivizumab may be appropriate, and to examine the potential impact of introducing prophylaxis with palivizumab on these patients and their economic management.Methods:We identified those infants deemed to be at high risk, matching the population recently studied by the Cardiac Synagis Group, from the database of the cardiology department of the hospital. The number of patients under the care of the paediatric cardiologists admitted to Alder Hey Hospital with respiratory syncytial viral bronchiolitis over the last three seasons was identified from hospital coding records, and the database of the cardiology department.Results:There are 131 patients at high risk each year. Of these, over the last three “bronchiolitis seasons”, 39 infants have been admitted to the hospital with bronchiolitis due to the respiratory syncytial virus. This represents a hospitalisation rate of 10 per cent, as was seen in the study of the Cardiac Synagis Group. Using a monthly dose of 15 milligrams per kilogram for five doses, the cost per patient is 2,650 pounds sterling for the season. To treat the 131 patients seen at Alder Hey, therefore, would cost 346,800 pounds each year. Applying the reductions in hospitalisation identified in the study by the Cardiac Synagis Group to our population would produce an expected reduction in patients hospitalised from 13 to 7 per year, reducing the total length of stay in our hospital wards from 169 to 76 days, and in the paediatric intensive care unit from 93 to 21 days. This amounts to a potential saving of 190,800 pounds per year. Reducing transfers to more distant paediatric intensive care units for referrals refused because of lack of beds could save an additional 50,000 pounds.Discussion:We estimate the net cost of introducing palivizumab for this population to be 106,000 pounds per year. There would, of course, be additional costs involved in setting up this service, as well as additional savings and benefits. This cost is comparable with other new biologic therapies now routinely used in the United Kingdom, such as etanercept for juvenile arthritis. There are, currently, no other obvious therapies that have the potential to reduce admissions to hospital and intensive care during the winter months, when beds are at their most scarce.

Paediatric intensive care admissions for respiratory syncytial virus bronchiolitis in France: results of a retrospective survey and evaluation of the validity of a medical information system programme

2011 ◽  
Vol 140 (4) ◽  
pp. 608-616 ◽  
Author(s):  
A.-L. SOILLY ◽  
C. FERDYNUS ◽  
O. DESPLANCHES ◽  
M. GRIMALDI ◽  
J. B. GOUYON
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Syncytial Virus ◽  
Medical Information ◽  
National Registry ◽  
Paediatric Intensive Care ◽  
Medical Information System ◽  
Retrospective Survey ◽  
Syncytial Virus ◽  
Systèmes D’Information

SUMMARYThe purpose of this study was to describe the characteristics of patients with bronchiolitis admitted to a paediatric intensive care unit (PICU), and to evaluate a national registry of hospitalizations (Programme de Médicalisation des Systèmes d'Information; PMSI) as a potential source of epidemiological data. Of the 49 French PICUs invited to take part in a retrospective survey of children aged <2 years who were hospitalized during the 2005–2006 epidemic season, 24 agreed to participate. Overall, 467 children were enrolled: 75% were aged <2 months, 76% had positive respiratory syncytial virus (RSV) tests, 34·9% required non-invasive ventilation, 36·6% were mechanically ventilated, and six infants died. The main neonatal characteristics were: prematurity (31·9%), respiratory disease (16·5%), congenital heart disease (6·4%), receiving mechanical ventilation (11·6%), and bronchopulmonary dysplasia at day 28 (3·8%). For bronchiolitis episode, the kappa coefficient between the survey and PMSI data was good only for mechanical ventilation (0·63) and the death rate (0·86).

scholarly journals Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

2021 ◽  
Author(s):  
Rosalie S. Linssen ◽  
◽  
Reinout A. Bem ◽  
Berber Kapitein ◽  
Katrien Oude Rengerink ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Syncytial Virus ◽  
The Netherlands ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
High Flow ◽  
Respiratory Support ◽  
High Flow Nasal Cannula ◽  
Non Invasive ◽  
Syncytial Virus

AbstractRespiratory syncytial virus (RSV) bronchiolitis causes substantial morbidity and mortality in young children, but insight into the burden of RSV bronchiolitis on pediatric intensive care units (PICUs) is limited. We aimed to determine the burden of RSV bronchiolitis on the PICUs in the Netherlands. Therefore, we identified all children ≤ 24 months of age with RSV bronchiolitis between 2003 and 2016 from a nationwide PICU registry. Subsequently we manually checked their patient records for correct diagnosis and collected patient characteristics, additional clinical data, respiratory support modes, and outcome. In total, 2161 children were admitted to the PICU for RSV bronchiolitis. The annual number of admissions increased significantly during the study period (β 4.05, SE 1.27, p = 0.01), and this increase was mostly driven by increased admissions in children up to 3 months old. Concomitantly, non-invasive respiratory support significantly increased (β 7.71, SE 0.92, p < 0.01), in particular the use of high flow nasal cannula (HFNC) (β 6.69, SE 0.96, p < 0.01), whereas the use of invasive ventilation remained stable.Conclusion: The burden of severe RSV bronchiolitis on PICUs has increased in the Netherlands. Concomitantly, the use of non-invasive respiratory support, especially HFNC, has increased. What is Known:• RSV bronchiolitis is a major cause of childhood morbidity and mortality and may require pediatric intensive care unit admission.• The field of pediatric critical care for severe bronchiolitis has changed due to increased non-invasive respiratory support options. What is New:• The burden of RSV bronchiolitis for the Dutch PICUs has increased. These data inform future strategic PICU resource planning and implementation of RSV preventive strategies.• There was a significant increase in the use of high flow nasal cannula at the PICU, but the use of invasive mechanical ventilation did not decrease.

The influence over a period of 8 years of patterns of prescribing palizivumab for patients with and without congenitally malformed hearts, and in admissions to paediatric intensive care

2009 ◽  
Vol 19 (4) ◽  
pp. 346-351 ◽  
Author(s):  
Alastair Turner ◽  
Colin Begg ◽  
Benjamin Smith ◽  
Jonathan Coutts
Keyword(s):  
Intensive Care Unit ◽  
United Kingdom ◽  
Intensive Care ◽  
Respiratory Syncytial Virus ◽  
Paediatric Intensive Care Unit ◽  
Paediatric Intensive Care ◽  
Number Of Children ◽  
Department Of Health ◽  
The United Kingdom ◽  
Syncytial Virus

AbstractObjectivesTo describe the pattern of prescribing for palivizumab in the Glasgow area over the period 1999 through 2007, and to compare recent prescribing to the current recommendations by the Joint Committee on Vaccination and Immunisation of the United Kingdom Department of Health. Our secondary objective was to describe admissions to paediatric intensive care in patients with respiratory syncytial virus receiving palivizumab.SettingTertiary children’s hospital out-patient immunisation clinic and paediatric intensive care unit.DesignProspective analysis of prescribing and admissions data for the period 1999 through 2007.Outcome measuresNumber of prescriptions and admissions to the paediatric intensive care unit.ResultsThe number of children receiving palivizumab annually initially rose more than 5-fold, from 17 in the season of 1999 and 2000 versus 115 in 2004 and 2005, although it has declined in the past 2 years, to 63 in 2006 and 2007, following publication of the recommendations of the Joint Committee on Vaccination and Immunisation established by the United Kingdom Department of Health. There has been no significant change in demographics of patients during this period. Prior to publication of these recommendations, 35 of 44 (80%) patients with congenitally malformed hearts who received palivizumab in the season of 2005 and 2006 deviated from the current recommendations, compared to 5 of 51 (10%) who received palivizumab for non-cardiac indications. No patients who received palivizumab required admission to the paediatric intensive care unit with proven respiratory syncytial virus infection over the 8 year period.ConclusionsThe number of children receiving palivizumab initially increased significantly, although it has now fallen following implementation of national recommendations. Much prescribing, particularly for children with congenitally malformed hearts, did not fulfil current recommendations. The absence of admissions to paediatric intensive care reflects the success of targeted immunisation in our population.

Respiratory Syncytial Virus Infection among Intubated Adults in a University Medical Intensive Care Unit

CHEST Journal ◽  
1991 ◽  
Vol 100 (5) ◽  
pp. 1377-1384 ◽  
Author(s):  
Gary Guidry ◽  
Cynthia A. Black-Payne ◽  
Keith Payne ◽  
Richard M. Jamison ◽  
Ronald B. George ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Syncytial Virus ◽  
Virus Infection ◽  
Respiratory Syncytial Virus Infection ◽  
Medical Intensive Care Unit ◽  
Medical Intensive Care ◽  
Syncytial Virus
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