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Right and left ventricular function in hospitalized children with respiratory syncytial virus infection

Authors Horter T, Nakstad B, Ashtari O, Solevåg AL

Received 7 May 2017

Accepted for publication 10 August 2017

Published 7 November 2017 Volume 2017:10 Pages 419—424


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony

Thorsten Horter,1 Britt Nakstad,1,2 Omid Ashtari,1 Anne Lee Solevåg1

1Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, 2Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Oslo, Norway

Background: Extrapulmonary manifestations including cardiac dysfunction have been demonstrated in children with respiratory syncytial virus (RSV) infection requiring intensive care. The aim of this study was to examine cardiac function in hospitalized children with moderate RSV infection admitted to a regular pediatric ward.
Methods: We used echocardiography to determine cardiac output, and right and left ventricular function in 26 patients (aged 2 weeks to 24 months) with RSV infection. The echocardiographic results were compared with s-troponin, the need for supplementary oxygen or noninvasive respiratory support, and capillary refill time.
Results: The number of measured s-troponins (ten [38%] of the included children) was too low to assess differences between children with elevated levels and those with normal levels. There were no differences in cardiac function between patients receiving oxygen treatment or respiratory support and those who did not. Capillary refill time did not correlate with any of the echocardiographic parameters. Both left and right ventricular output (mL/kg/min) was higher than published reference values. All other echocardiographic parameters were within the reference range.
Conclusion: Children with moderate RSV infection had an increased left and right ventricular output, and cardiac function was well maintained. We conclude that routine cardiac ultrasound is not warranted in children with moderate RSV infection. The role of an elevated s-troponin in these patients remains to be determined.

Keywords: bronchiolitis, capillary refill time, child, echocardiography, respiratory syncytial virus

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