Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of admission and management variation in patients hospitalized with respiratory syncytial viral lower respiratory tract infection

Wang, Elaine E. L.; Law, Barbara; Boucher, François D.; Stephens, Derek; Robinson, Joan; Dobson, Simon; Langley, Joanne M.; McDonald, Jane; MacDonald, Noni E.; Mitchell, Ian

doi:10.1016/s0022-3476(96)70071-9

Cited by 197 publications

(124 citation statements)

References 10 publications

Supporting

Mentioning

105

Contrasting

Unclassified

Order By: Relevance

“…Use of corticosteroids has been reported in up to 60% of hospitalized patients with RSV bronchiolitis (36). A systematic review of the effect of corticosteroids on nonintubated infants with bronchiolitis showed a 0.5-day decrease in duration of hospitalization (37).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of interventions for bronchiolitis in critically ill infants: A systematic review and meta-analysis*

Davison

Ventre²,

Luchetti³

et al. 2004

Pediatric Critical Care Medicine

100

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy of interventions for bronchiolitis in critically ill infants: A systematic review and meta-analysis*

Davison

Ventre²,

Luchetti³

et al. 2004

Pediatric Critical Care Medicine

100

View full text Add to dashboard Cite

show abstract

“…[20][21][22]24 Furthermore, aerosolized ribavirin is very expensive, requires special equipment and may be toxic. 19,25,26 In addition to therapy with aerosolized ribavirin and IVIG, delay in the treatment of the underlying cancer has been recommended with potential negative effect on the patient's underlying disease.…”

mentioning

confidence: 99%

Patients with multiple myeloma may safely undergo autologous transplantation despite ongoing RSV infection and no ribavirin therapy

Aslan

Fassas

Siegel

et al. 1999

Bone Marrow Transplant

View full text Add to dashboard Cite

Summary:Respiratory syncytial virus (RSV) has been reported as a cause of death among autologous peripheral blood stem cell (ASCT) and marrow recipients and recommendations for therapy with aerosolized ribavirin plus intravenous immunoglobulin (IVIG) made. This therapy is expensive, may be toxic, and causes a significant disruption of patient care. The purpose of this study was to evaluate the morbidity and mortality of RSV infections in patients with multiple myeloma undergoing ASCT without ribavirin therapy. During the months of February-April 1997, 10 consecutive patients (median age 57 years, seven males) with advanced and heavily pretreated myeloma underwent ASCT while having active RSV upper respiratory tract infection. After melphalan (200 mg/m 2 ), all patients became neutropenic (Ͻ1000 cells/mm 3 ) for a median of 7 days. Ribavirin was not given to any patient. No patient developed lower respiratory tract infection, required transfer to intensive care or died at a median follow-up of 8 months. One patient developed tracheobronchitis requiring oxygenation by nasal cannula. No delay in the treatment of the underlying myeloma was incurred. RSV infection may not necessarily be a contraindication for ASCT or an indication for therapy with aerosolized ribavirin. Additional studies are needed to confirm our preliminary findings. Keywords: multiple myeloma; ribavirin; RSV infection; bone marrow or stem cell transplantation Viral infections represent a challenging problem in immunocompromised patients. 1-3 Respiratory syncytial virus (RSV) is an important community and nosocomial respiratory pathogen for infants, young children and immunocompromised adults. 4 RSV causes especially severe disease in the prematurely born, the elderly and in patients with chronic cardiopulmonary diseases or T cell deficiencies, such as peripheral stem cell or marrow transplant recipients. 5 solized ribavirin and high-dose IVIG has been recently recommended for the treatment of RSV upper respiratory tract infections on the basis of an uncontrolled study from a single center. 6 However, this approach has never been evaluated in randomized trials in adults. The trials in pediatric RSV infections gave conflicting results: some showing clinical improvement, 7-13 while others showed no benefit [14][15][16][17][18] or even a detrimental effect (eg prolonged duration of hospitalization, intensive care unit stay, duration of hypoxia, and mechanical ventilation) [19][20][21][22][23][24] (Table 1). A recent metaanalysis of randomized trials concluded that the administration of ribavirin in pediatric RSV infections is not supported by the clinical studies and does not result in decreases in length of hospital stay or mortality rate. 18 More recent studies which included significantly larger numbers of patients than earlier reports, concluded that aerosolized ribavirin was detrimental to infants with RSV infection. [20][21][22]24

show abstract

“…24,25,[27][28][29] No statistically significant difference was observed between IL-2 levels in nasopharyngeal secretion and disease severity assessed by hemoglobin oxygen saturation (pulse oximetry), Modified Clinical Scoring System, time on supplemental oxygen, length of hospital stay, and necessity of MV. Necessity of intensive care admission was not considered in the assessment of disease severity, since patients were selected from two hospitals with distinct healthcare characteristics.…”

Section: Discussionmentioning

confidence: 94%

Concentrações de interleucina-2 na secreção nasofaríngea de crianças com bronquiolite viral aguda pelo vírus respiratório sincicial

Giugno¹,

Amantéa²,

Barreto³

2004

J. Pediatr. (Rio J.)

View full text Add to dashboard Cite

Objective: To assess interleukin-2 concentrations in nasopharyngeal secretion of children (0-24 months) with acute respiratory syncytial virus bronchiolitis, within the first 12 hours of hospital admission, and compare the levels of IL-2 with the severity of the illness.Methods: Prospective study performed between June and August 1999. The study included 62 patients, previously healthy, hospitalized with acute viral bronchiolitis characterized by recent prodromes of coryza and/or nasal obstruction, which evolved to at least two of the following signs: respiratory dysfunction, tachypnea, wheezing or rales, and detection of respiratory syncytial virus in nasopharyngeal aspirate. The nasopharyngeal specimens were collected within 12 hours of hospital admission. The interleukin-2 levels were obtained by enzyme immunoassay. Severity of illness was assessed through oxygen saturation by pulse oximetry, Modified Clinical Score System, time of supplemental oxygen required, length of hospital stay, and mechanical ventilation. Spearman s correlation and Kruskal-Wallis test were used to compared these variables in relation to the median of interleukin-2. The chi-square test was used for categorical analysis of interleukin-2.Results: The mean age of patients was 2.2 (1.3-4) months. Males comprised 54% of cases. Hemoglobin oxygen saturation by pulse oximetry at hospital admission was below 95% in 66.1% of patients. The mean time of supplemental oxygen use was 4.7 days (±3.54). The mean length of hospital stay was 4.25 days (±1.76). Mechanical ventilation was used in 4.8% of patients. The values of interleukin-2 in nasopharyngeal aspirates varied from 0 to 40,256 ng/ml with median of 86 ng/ml (4.4 457.3). The study showed no statistical difference between levels of IL-2 and severity of illness. Conclusions:The interleukin-2 levels showed a heterogeneous behavior. We found no association between interleukin-2 levels in nasopharyngeal secretion and respiratory syncytial virus bronchiolitis.J Pediatr (Rio J). 2004;80(4):315-20: Interleukin-2, acute viral bronchiolitis, respiratory syncytial virus, nasopharyngeal aspirates.

show abstract

Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of admission and management variation in patients hospitalized with respiratory syncytial viral lower respiratory tract infection

Cited by 197 publications

References 10 publications

Efficacy of interventions for bronchiolitis in critically ill infants: A systematic review and meta-analysis*

Efficacy of interventions for bronchiolitis in critically ill infants: A systematic review and meta-analysis*

Patients with multiple myeloma may safely undergo autologous transplantation despite ongoing RSV infection and no ribavirin therapy

Concentrações de interleucina-2 na secreção nasofaríngea de crianças com bronquiolite viral aguda pelo vírus respiratório sincicial

Contact Info

Product

Resources

About