Surveillance of oxygen-dependent infants with pulmonary sequelae probably caused by viral infection
First national report
Keywords:
RESPIRATORY DISEASES, CHRONIC DISEASE, OXYGEN INHALATION THERAPY, HOME CARE SERVICES PROVIDED BY HOSPITAL, FOLLOW-UP STUDIES, CHILD, URUGUAYAbstract
Objective: To describe the first experience of ambulatory assistance of oxygen-dependent children suffering chronic respiratory disease probably caused by viral infection.
Materials and methods: Clinic histories of every affected child between April of 1999 and April of 2000 were analized.
Results: Sixteen children fulfilled the diagnostic criteria. At the beginning of the disease the average age was 10 months. Twelve out of sixteen needed long mechanic ventilatory assistance (26 days mean). The respiratory syncytial virus (RSV) was identified in two patients, adenovirus in other two patients and influenza B in one. During the follow-up period, all patients had cough and chest tightness. Hyper-insuflation and diffuse interstitial compromise appeared as constant radiological findings. Mosaic tomographic pattern was predominant (9/10). Only one patient developed pulmonary hypertension. It was possible to interrupt oxygen-therapy in six cases. The main cause of re-enter was low respiratory infection that caused the only death that was registered during that period.
Conclusions: Institutional support is seen as essential to continue with this home-assistance project.
References
2) Hortal M, Benítez A, Contera M. A Comunity Base Study of Acute Respiratory Tract Infections in children in Uruguay. Rev Infect Dis 1990; 12(8): 966-73.
3) Hortal M, Russi JC, Arbiza J, Martorell E, Chiparelli H, et al. Infecciones respiratorias agudas en niños menores de 5 años hospitalizados. Estudio etiológico prospectivo. Rev Med Uruguay 1986; 3: 213-6.
4) Hortal M, Ferrari AM, Russi JC, Estevan M. Infecciones respiratorias agudas intratorácicas en niños hospitalizados. Uruguay 1984-1986. Bol Med Hosp Infant Mex 1990; 47(9): 624-9.
5) Hortal M, Russi JC, Arbiza JR. Identification of Viruses in a Study of Acute Respiratory Tract infection in children from Uruguay. Rev Infect Dis 1990; 12(8): 995-7.
6) Orive P, Casado Flores J, García Teresa M. Infecciones respiratorias agudas en unidades de cuidados intensivos pediátricos. Estudio prospectivo multicéntrico. An Esp Pediatr 1998; 48(2): 138-42.
7) Berman S. Epidemiology of Acute Respiratory Infections in Children of Developing Countries. Rev Infect Dis 1991; 13: 454-62.
8) Mercado S, Spremolla A, Falco A, Alberti M, Martínez O. Neumonía viral en niños menores de 2 años ingresados en una unidad de cuidados intensivos. Congreso Latinoamericano de Pediatría, 12, Montevideo: 2000.
9) Massie R, Armstrong D. Bronchiectasis and Bronchiolitis obliterans post respiratory syncytial virus infection: think again. J Pediatr Child Health 1999; 35(5): 497-8.
10) Deschildre A. Séquelles á moyen et á long terme des pneumopathies communautaires de l'enfant. Arch Pédiatr 1998; 5(suppl.1): 45-8.
11) Lombet J. Price en charge á domicile de la dysplasie bronchopulmonaire. Arch Pédiatr 1998; 5: 442-8.
12) Darville T, Yamauchi T. Virus Sincicial respiratorio. Pediatr Rev (en español) 1998; 19: 126-32.
13) Wong DL. Impacto de la enfermedad crónica, la incapacidad o la muerte en el niño y la familia. In: Whaley, Wong DL. Enfermería pediátrica. 4a edición. Madrid: Mosby, 1995: 474-513.
14) Müller N, Miller R. Diseases of the bronchioles: CT and Histopathologic findings. Radiology 1995; 196: 3-12.
15) Webb WR. High Resolution CT of the Lung Parenchyma. Radiol Clin North Am 1989; 27(6): 1085-97.
16) Kuhn J. High Resolution CT of Pediatric Pulmonary Parenchymal disorders. Radiol Clin North Am 1993; 31(3): 533-51
17) Wesley AG, Pather M, Tait D. Nosocomial adenovirus infection in a pediatrics respiratory unit. J Hosp Infect 1993; 25: 183-90.
18) Murtagh P, Kajon A. Chronic Pulmonary Sequelae of Adenovirus infection. Pediatr Pulmonol 1997; (16 Suppl): 150-1.
19) Kajon A, Wadell G. Charecterization of adenovirus genome type 7h: analysis of its relationship to other members of serotype 7. Intervirology 1992; 33: 86-90.
20) Kajon A, Wadell G. Genoma analysis of South American adenovirus strains of serotype 7 collected over a 7 years period. J Clin Microbiol 1994; 32: 2321-3.
21) Larrañaga C, Avendaño L, Gaggero A. Diagnóstico de infección por adenovirus y virus respiratorio sincicial en lactante. Comparación entre aislamiento e inmunofluorescencia indirecta. Rev Chil Infect 1990; 7(3): 167-71.
22) Clark RH. Medical Progress: High Frequency ventilation. J Pediatr 1994; 124(5): 661-70.
23) Slutsk A. Lung injury caused by mechanical ventilation. Chest 1999; 116 (Suppl 1): 9s-15s.
24) Laraya-Cuasay LR, DeForest A, Huff D. Chronic Pulmonary complications of early influenza virus infections in children. Am Rev Respir Dis 1977; 116: 617-25.
25) Hardy KA, Schidlow DV, Zaeri N. Obliterative broncholitis in children. Chest 1988; 93: 460-66.
26) Wohl ME. "Bronchiolitis obliterans" In: Chernick V, Boat T. Kendig's Disordes of the Respiratory Tract in Children, 6ª Edition, Philadelphia: WB Saunders, 1998: 480-2.
27) Teper A, Kofman C, Maffey A, Vidaurreta S. Lung function in infants with chronic pulmonary disease after severe adenoviral illness. J Pediatr 1999; 134(6): 730-3.
28) Teel G, Engeler C. Imaging of Small Airways Disease. Radiographics 1996; 16: 27-41.
29) Lynch D, Brasch R. Pediatric Pulmonary Disease: Assesment with High Resolution ultrafast CT. Radiology 1990; 176: 243-8.
30) Siegel M. Lung, Pleura and Chest wall. In: Pediatric body CT, Lippincott: Williams Wilkins, 1999: 101-40.
31) Dueñas Meza E. "Secuelas de la infección viral" In: Reyes, Aristizábal, Leal. Neumología Pediátrica: Infección, Alergia y Enfermedad Respiratoria en el niño. 3ª Ed, Buenos Aires: Médica Panamericana, 1998: 479-92.