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?

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.

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An Active Surveillance and Referral Program to Ensure Respiratory Syncytial Virus Prophylaxis for the Pediatric Congenital Heart Disease Population: A Quality Improvement Project

Clinical Scholars Review ◽

10.1891/1939-2095.7.2.154 ◽

2014 ◽

Vol 7 (2) ◽

pp. 154-159

Author(s):

Carman R. DeMare ◽

Catherine O’Keefe

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Respiratory Syncytial Virus ◽

Congenital Heart ◽

Data Entry ◽

Cross Sectional Study ◽

Cross Sectional ◽

Improvement Project ◽

Number Of Patients ◽

Syncytial Virus

Background: Congenital heart disease (CHD) is the leading cause of death within the first year of life because of birth defects. Complications related to respiratory infection caused by respiratory syncytial virus (RSV) increase risks in the CHD population. Prevention is key to minimizing risk, and administration of RSV prophylaxis, palivizumab, is recommended for infants with hemodynamically significant heart disease. Objective: Use the electronic medical record (EMR) to identify and ensure appropriate referral of CHD patients eligible for RSV prophylaxis. Design: Comparative, cross-sectional study design. Setting: Cardiac specialty clinic of a regional children’s hospital. Population: CHD patients younger than 24 months of age eligible for RSV prophylaxis. Intervention: Use the EMR to develop a method for identifying CHD patients eligible for RSV prophylaxis and implement a referral process. Results: Similar number of patients in the 2 RSV seasons studied. Rates of eligibility for RSV prophylaxis over the 2 seasons were the same. Improvements in documentation of eligibility by the provider from the first season to the second. Limitations: Inability to determine referral rates. Initial EMR search did not identify patients eligible for RSV prophylaxis. Inconsistent EMR data entry. Conclusions: Ongoing education on eligibility for RSV prophylaxis. Need for automated EMR referral. Ongoing evaluation of EMR systems identifying patients eligible for RSV prophylaxis.

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Respiracinio sincitinio viruso infekcijos aktualumas vaikų kardiochirurgijoje

Lietuvos chirurgija ◽

10.15388/lietchirur.2007.3.2227 ◽

2007 ◽

Vol 5 (3) ◽

pp. 0-0

Author(s):

Solveiga Umbrasaitė ◽

Kęstutis Versockas

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Respiratory Syncytial Virus ◽

Congenital Heart ◽

Severe Form ◽

University Hospital ◽

Rsv Infection ◽

Syncytial Virus ◽

One Year ◽

Tract Infections

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

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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.

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