Abstract
Bronchiolitis is the most common infection of the lower airways of the 1st year. Infants with severe respiratory distress (2-3%) require hospital care. The aim of the study is to evaluate the frequency of Respiratory Virus (VRS) infection, the usefulness of the diagnostic score, the ventilatory support and the protective effect of vaccinations. 173 patients <2years admitted to 5 hospitals divided into two groups on the basis of gestational age (EG) and weight (P) were enrolled: the first (1G) of 106 (EG 38.9≤1 w, P 3253≤385,7 g) and the second (2G) of 67 (EG 35.6≤2.44 w, P 2549.8≤467.7 g). A severity score (SG) was used based on the presence of risk factors, of SaO2 <92%, respiratory distress. Age of onset, respiratory support, vaccinations, and prophylaxis with Palivizumab was evaluated.
Highlights
Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract illness in infants and young children, causing annual epidemics
The American Academy of Pediatrics Committee on Infectious Diseases (COID) in mid-2014 recommended against the use of RSV immunoprophylaxis (RSV IP) among preterm infants born at 29 to 35wGA except for those with another qualifying medical condition, such as chronic lung disease of prematurity (CLDP) or hemodynamically significant congenital heart disease (HS-CHD) [2]
In moderately preterm infants born at 32–35 weeks gestational age (WGA), it is reported that about 9% of infants require mechanical ventilation at a paediatric intensive care unit (PICU) [9]
Summary
Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract illness in infants and young children, causing annual epidemics. RSV is estimated to cause up to 75% of all infant bronchiolitis and 40% of all pediatric pneumonias [1]. The American Academy of Pediatrics Committee on Infectious Diseases (COID) in mid-2014 recommended against the use of RSV IP among preterm infants born at 29 to 35wGA except for those with another qualifying medical condition, such as chronic lung disease of prematurity (CLDP) or hemodynamically significant congenital heart disease (HS-CHD) [2]. Current Italian Guidelines recommend with a Level of Evidence II and Strength of recommendation A that: for infants of 29–35 weeks gestational age and age ≤6 months at the beginning of the epidemic season, prophylaxis with palivizumab might be taken into consideration in presence of risk conditions predisposing to severe infections and/or need for hospitalization [3,4]. We point out the protect role of immunoprophylaxis to prevent the illness and to avoid hospitalization
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