OBJECTIVE: Respiratory syncytial virus (RSV) infection is associated with a number of extrapulmonary manifestations, including a sepsis-like syndrome characterized by any combination of hypothermia, fever, apnea, hypovolemia, and myocardial dysfunction. We hypothesized that RSV can have a direct injurious effect on the myocardium of infants and children that can be detected by the presence of cardiac troponin I (cTnI), a highly sensitive and specific marker of myocardial injury, in the blood of patients infected with the virus. DESIGN: Serial cTnI measurements were obtained from patients admitted with documented RSV infection to the pediatric intensive care unit (PICU). PARTICIPANTS: Data were collected and analyzed from 22 RSV infected patients and 11 control patients. RESULTS: Elevated levels of cTnI were detected in 54.5% (12/22) of the study population during their PICU admission. The average cTnI level was significantly higher in the RSV infected group than in controls. There was a significant association between the presence of a positive troponin assay and the occurrence of a cardiovascular event, the need for inotropic support, and the requirement of mechanical ventilation. Patients who required inotropic support had a significantly higher cTnI level than the rest of the study population. CONCLUSION: A large percentage of children admitted to the PICU with RSV infection have myocardial damage as detected by the use of commercially available troponin assays. Additionally, in a portion of these patients, this damage is clinically significant, leading to cardiovascular instability and the need for inotropic support.
OBJECTIVE:Respiratory syncytial virus (RSV) infection is associated with a number of extrapulmonary manifestations, including a sepsis-like syndrome characterized by any combination of hypothermia, fever, apnea, hypovolemia, and myocardial dysfunction. We hypothesized that RSV can have a direct injurious effect on the myocardium of infants and children that can be detected by the presence of cardiac troponin I (cTnI), a highly sensitive and specific marker of myocardial injury, in the blood of patients infected with the virus. DESIGN: Serial cTnI measurements were obtained from patients admitted with documented RSV infection to the pediatric intensive care unit (PICU). PARTICIPANTS: Data were collected and analyzed from 22 RSV infectedpatients and 11 control patients. RESULTS: Elevated levels of cTnI were detected in 54.5% (12/22) of the study population during their PICU admission. The average cTnI level was significantly higher in the RSV infected group than in controls. There was a significant association between the presence of a positive troponin assay and the occurrence of a cardiovascular event, the need for inotropic support, and the requirement of mechanical ventilation. Patients who required inotropic support had a significantly higher cTnI level than the rest of the study population. CONCLUSION: A large percentage of children admitted to the PICU with RSV infection have myocardial damage as detected by the use of commercially available troponin assays. Additionally, in a portion of these patients, this damage is clinically significant, leading to cardiovascular instability and the need for inotropic support.
Authors: Mark G Thompson; Danielle R Hunt; Ali K Arbaji; Artan Simaku; Veronica L Tallo; Holly M Biggs; Carolyn Kulb; Aubree Gordon; Ilham Abu Khader; Silvia Bino; Marilla G Lucero; Eduardo Azziz-Baumgartner; Pat Shifflett; Felix Sanchez; Basima I Marar; Ilirjana Bakalli; Eric A F Simões; Min Z Levine; Jennifer K Meece; Angel Balmaseda; Tareq M Al-Sanouri; Majlinda Dhimolea; Joanne N de Jesus; Natalie J Thornburg; Susan I Gerber; Lionel Gresh Journal: BMC Infect Dis Date: 2017-03-22 Impact factor: 3.090
Authors: Karen Bohmwald; Janyra A Espinoza; Emma Rey-Jurado; Roberto S Gómez; Pablo A González; Susan M Bueno; Claudia A Riedel; Alexis M Kalergis Journal: Semin Respir Crit Care Med Date: 2016-08-03 Impact factor: 3.119
Authors: A Gavotto; A Ousselin; O Pidoux; P Cathala; V Costes-Martineau; B Rivière; J L Pasquié; P Amedro; C Rambaud; G Cambonie Journal: BMC Pediatr Date: 2019-11-27 Impact factor: 2.125