Hospitalizations for respiratory syncytial virus bronchiolitis in preterm infants at <33 weeks gestation without bronchopulmonary dysplasia: the CASTOR study

Abstract

SUMMARYThis study was conducted during the 2008–2009 respiratory syncytial virus (RSV) season in France to compare hospitalization rates for bronchiolitis (RSV-confirmed and all types) between very preterm infants (<33 weeks' gestational age, WGA) without bronchopulmonary dysplasia and full-term infants (39–41 WGA) matched for date of birth, gender and birth location, and to evaluate the country-specific risk factors for bronchiolitis hospitalization. Data on hospitalizations were collected both retrospectively and prospectively for 498 matched infants (249 per group) aged <6 months at the beginning of the RSV season. Compared to full-term infants, preterm infants had a fourfold [95% confidence interval (CI) 1·36–11·80] and a sevenfold (95% CI 2·79–17·57) higher risk of being hospitalized for bronchiolitis, RSV-confirmed and all types, respectively. Prematurity was the only factor that significantly increased the risk of being hospitalized for bronchiolitis. The risk of multiple hospitalizations for bronchiolitis in the same infant significantly increased with male gender and the presence of siblings aged ⩾2 years.

Maternal inflammation modulates infant immune response patterns to viral lung challenge in a murine model

“…Preterm human infants can exhibit severe responses to infections such as RSV (13), which has been linked to increased inflammatory cytokines in cord blood (14). Consistent with this, in the present study, we observed exaggerated inflammatory cellular responses to SeV lung challenge in LPS-exposed pups relative to infected neonates without such exposure.…”

“…Paradoxically, clinical and experimental observations suggest that even preterm neonates can mount exaggerated inflammatory responses to infectious stimuli that could contribute to chronic morbidity or mortality (13)(14)(15)(16)(17). The mechanisms underlying this "hyper-inflammatory" phenotype are not well understood, although some evidence implicates impaired innate and adaptive immune interactions that disrupt homeostatic balance (7).…”

Ventilação mecânica não invasiva na bronquiolite viral aguda: estudo de coorte retrospectivo

“…Um estudo realizado na França comparou a taxa de hospitalização por BVA de crianças prematuras (idade gestacional <33 semanas) com crianças nascidas a termo e encontrou uma taxa de hospitalização significativamente maior no primeiro grupo (14,1% versus 2,0%; p<0,0001). Além disso, o grupo de prematuros apresentou um risco sete vezes maior de internação comparado ao grupo de nascidos a termo, todos com idade inferior a seis meses 25 . A pronga nasal foi a interface utilizada pelos 14 pacientes.…”

Watershed stroke - an unexpected complication of respiratory syncytial virus bronchiolitis: a case report

“…Peripheral perfusion failure (ischemia) is the critical physiological process most likely secondary to precipitous drops in systemic arterial blood pressure rather than hypoxia [1]. Microembolic disease has also been implicated in the etiology of WSI [2][3].…”

“…Various pathophysiological origins have been alluded to -such as systemic hypotension, arterial stenosis/occlusion and microemboli [1][2][3]. In the newborn, after 36 weeks gestational age, it is generally thought to arise from severe systemic hypotensive episodes ± hypoxemia [4].…”