EVALUATION OF CHILDREN (<2 YEARS OLD) WITH RESPIRATORY SYNCYTIAL VIRUS BRONCHIOLITIS IN TERMS OF DİSEASE COURSE AND THE REQUIREMENTS OF ADDITIONAL TREATMENT
Authors/Creators
- 1. Department of Pediatrics, Pediatric Emergency Unit, Umraniye Training and Research Hospital, İstanbul, Turkey.
- 2. Department of Pediatrics, Burtom Konur Surgical Medical Center, Bursa, Turkey.
- 3. Department of Pediatrics, Antalya Kepez State Hospital, Antalya, Turkey.
- 4. Department of Pediatrics, Kartal Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey.
- 5. Department of Pediatrics, Pediatric Infection Disease Unit, Pendik Training and Research Hospital, Marmara University Faculty of Medicine, İstanbul, Turkey.
- 6. Department of Pediatrics, Ankara Research and Treaning Hospital, Ankara, Turkey
- 7. Department of Biostatistics and Informatics, Yeditepe University Faculty of Medicine, İstanbul, Turkey
Description
Purpose:To evaluate the demographic and clinical characteristics of children and the types and frequencies of treatments given in the setting of respiratory syncytial virus (RSV) bronchiolitis.
Material and Method:Sixty-three children (39 females, 24 males;mean age 8.7 months; range 2 to 24 months) were diagnosed with acute bronchiolitis due to RSV betweenNovember 2017 to February 2018. The microbiologicaldiagnosiswas made with the detection of RSV antigens by the immunochromatographic assay. Retrospective data included risk factors, symptoms and signs at presentation, laboratory and radiographic findings, and treatment methods.
Results:Fifty-three patients (84.1%) were younger than 12 months. The birth weights were between 1,600 and 4,250 g and the gestational ages were between 31 and 41 weeks. Prematurity was found in 11 patients (17.5%), and comorbid conditions 17 patients (27%). Hospitalization was required in 34 patients (54%), of whom three patients (4.8%) were further admitted to the intensive care unit.The following treatment modalities were more frequently used: multiple bronchodilators for comorbidities (35.3%), tachypnea (29.7%); inhaled steroid therapy for hypoxemia (90.9%), tachypnea (89.2%); systemic steroid treatment for tachypnea (40.5%); intravenous fluid therapy for tachypnea (78.4%); antibiotherapyfor comorbidities (76.5%). Hospitalization was more frequently required in patients with tachypnea (83.8%) and, hypercarbia (83.3%). Treatment methods significantly differed between patients with and without comorbidity, age <12 months, tachypnea. (p<0.05).
Conclusions:The presence of comorbid conditions and tachypnea seems to play a critical role in determining the need for treatment. Tachypnea as a symptom can help predict the need for hospitalization, as well as multiple bronchodilator therapy, steroid therapy, and antibiotic use for the treatment. The presence of tachypnea, hypoxemia, comorbidity, and radiographic infiltration seems to be associated with the need for antibiotics. In addition, the presence of infiltration on chest X-ray, acidosis, hypoxemia, and hypercarbia are also indicators of hospitalization.