Evaluation of Children with Congenital Heart Disease Hospitalized with the Diagnosis of Lower Respiratory Tract Infection

Abstract

Lower respiratory tract infections are an important reason for mortality and morbidity in children with congenital heart disease. This study aimed to evaluate 50 children who had congenital heart disease and were hospitalized with lower respiratory tract infection in the Ege University Faculty of Medicine Pediatrics Hospital. Materials and Methods: Fifty pediatric patients were taken into the study. Their clinical symptoms, acute phase reactants, chest X-rays, bacterial culture of transtracheal aspirate, respiratory virus panel (with multiplex polimerase chain reaction) from nasopharyngeal swab were examined. The groups were evaluated in terms of age, gender, enviromental smoke exposure, living with school-aged siblings, Respiratory Syncytial virus (RSV) prophylaxis, hospitalization time, causative pathogen, additional risk factors. Results: Of the 50 cases, 12 (24%) were cyanotic, 38 (76%) were acyanotic. There were 26 boys and 24 girls. The most common diagnosis in the acyanotic group was hemodynamically significant VSD (isolated or with other diagnoses) with 20 cases. The average age of the cyanotic group was 23.88±28.81, and the acyanotic group was 12.25±15.45 months old. Hospitalizations most frequently occured in winter. The most frequent viral agent was RSV, which was not seen in the cyanotic group. All of the RSV infected patients were under 12 months old. In 16.7% of cyanotic and 52.6% of acyanotic patients there were extra risk factors such as immune deficiency, Down syndrome, prematurity, Di George syndrome, cerebral palsy, postoperative early period. Three cases lost their lives due to severe respiratory failure. There was no statistically significant difference between the two groups when compared for demografic variables, risk factors, causative pathogens, hospitalization times. Conclusion: Lower respiratory tract infections and especifically RSV pneumonia are important causes of mortality and morbidity in patients diagnosed with congenital heart disease. To prevent risk factors, more studies must be done.

Content validity of the nursing diagnostic Breathing Pattern, Ineffective, in children with congenital heart defects

“…Several factors reinforce the relation between the associated condition "increased resistance in air passages" and the ND BPI in children with CHD, among which the following stand out: abnormal anatomic structures, high prevalence of lung hypertension and increased lung blood flow, in addition to recurring respiratory tract infections (17)(18)(19)(20)(21) . All these conditions contribute to make the passage of air more difficult, thus generating an increase in the resistance of air passages and impairing ventilation.…”

Virus respiratorios y características clínico-epidemiológicas en los episodios de infección respiratoria aguda

“…Este estudio registró que el VRS fue el principal patógeno identificado, con una alta tasa de detección en los casos con EC-AR (4/18) y con MC-SO (5/14); sin embargo, se considera que para un mejor análisis se debería contar con una muestra más grande de aquellas patologías. El hallazgo de VRS en los casos con EC-SC (13,1%) fue similar a lo reportado previamente (15,16) ; mientras que en NH, la frecuencia viral (6,3%) fue menor en comparación a otros estudios (7% a 42%) (17) ; en la unidad de cuidados intensivos neonatal no se registró ninguna detección viral en comparación con un estudio que reportó un 47% de infección (18) . El presente estudio se llevó a cabo utilizando un panel de detección para los principales virus causantes de IRA, un número considerablemente grande de episodios de IRA, incluyendo todas las edades pediátricas, casos hospitalizados como ambulatorios, con diferentes patologías preexistentes y durante un periodo de 2 años, permitiendo evaluar tendencias estacionales.…”

Anaemia in solitary acyanotic ventricular septal defect in comorbid with pneumonia or pulmonary hypertension: A retrospective study of 75 paediatric cases

“…PNA, defined as an inflammation of alveoli (with or without pus) due to an infection is a serious morbidity and mortality reason for children (≤2years) with hemodynamic significant VSD 5,13 . Similar to PH, inflammatory state in PNA causes pulmonary oedema, homeostasis and hypoxia, with subsequent upregulation of erythrocyte synthesis 8,14 .…”