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Abstract
Purpose
To investigate the clinical characteristics and the risk factors for mechanical ventilator treatment and incidence of complications in children admitted to an intensive care unit (ICU) with detected respiratory viruses.
Methods
Eighty-two patients who were detected respiratory viruses by multiplex real-time polymerase chain reaction from nasopharyngeal aspirates were enrolled among the 123 children admitted to ICU with acute respiratory manifestations during the study period from January 2006 to December 2012.
Results
Detection rate of respiratory viruses were 66% and 13 patients (16%) had two viruses isolated. The most common respiratory virus isolated was respiratory syncytial virus (RSV) (35%) followed by rhinovirus (19%), adenovirus (13%), parainfluenza virus (11%), influenza virus (11%), human metapneumovirus (6%), and human coronavirus (5%). Pneumonia (70%) was the most common clinical diagnosis. The mean age of patient with RSV infection was the youngest and with influenza virus infection was the oldest among other viruses infection (mean±standard deviation, 5.9±10.1 months vs. 51.0±26.1 months; P=0.01). Forty Patients (49%) who had the underlying diseases were not associated with incidence of mechanical ventilator treatment and complications. Bacterial coinfection with respiratory virus was the significant risk factor of mechanical ventilator care and incidence of complications (odds ratio [OR], 50.003; 95% confidence interval [CI], 3.955-632.144; P=0.003, and OR, 15,569; 95% CI, 1.803-134.452; P=0.013).
Figures and Tables
Fig. 1
Incidence of respiratory viruses detected in pediatric patients admitted to intensive care unit with acute respiratory manifestations. RSV, respiratory syncytial virus; hRV, human rhinovirus; ADV, adenovirus; PIV, parainfluenza virus; IFV, influenza virus; hMPV, human metapneumovirus; CoV, coronavirus.
Fig. 2
Monthly distribution of respiratory viruses detected. CoV, coronavirus; hMPV, human metapneumovirus; hRV, human rhinovirus; IFV, influenza virus; ADV, adenovirus; PIV, parainfluenza virus; RSV, respiratory syncytial virus.
Table 2
The clinical characteristics and diseases association of respiratory viruses infection
Values are presented as mean±standard deviation or number (%).
RSV, respiratory syncytial virus; ADV, adenovirus; hRV, human rhinovirus; IFV, influenza virus; hMPV, human metapneumovirus; PIV, parainfluenza virus; CoV, coronavirus; WBC, white blood cell; CRP, C-reactive protein; ICU, intensive care unit.
*Kruskal-Wallis test. †Fisher exact test.
Table 3
Evaluating risk factors on the treatment of mechanical ventilation
Values are presented as number (%) or mean±standard deviation.
OR, odds ratio; CI, confidence interval; ER, emergency room; CRP, C-reactive protein.
*Age at admission. †Admission route to intensive care unit. ‡Prematurity, ventricular septal defect, Down syndrome, Cornelia de Lange syndrome, asthma, spinal muscular dystrophy, malignancy, cerebral palsy.
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