Abstract

GOMEZ CARRASCO, J.Á. et al. Analysis of the children admitted to a Pediatric department because of respiratory syncytial virus bronchiolitis, during two periods separated by 5 years, and its relation with recurrent wheezing after discharge. Rev Pediatr Aten Primaria [online]. 2009, vol.11, n.42, pp.207-218. ISSN 1139-7632.

Introduction: bronchiolitis is the most frequent infection of the lower respiratory tract among infants under 1 year and a significant cause of hospitalization. Respiratory syncytial virus is the causal agent in 70%-80% of the cases. Our main goal was to check if different therapeutic tendencies over time have caused variations in clinical results. Patients and methodology: the study includes infants under 2 years of age admitted to our Pediatrics Department after a first episode of respiratory syncytial virus bronchiolitis, during two periods separated by 5 years (2000-2001 and 2005-2006). Epidemiological, clinical and treatment differences between these two periods were analyzed. Subsequently, the families of patients admitted to hospital during the second period were interviewed by phone in order to obtain clinical and epidemiological information about the evolution of the disease after hospital discharge. Results: one hundred and ten patients were included; 56 from the first period (20002001) and 54 from the second (2005-2006). The respiratory syncytial virus bronchiolitis, in our sample, affected mainly to infants under 1 year, with an average age of 4.8 months when admitted, most of them were male (65.5%) and during the winter season (November-February). Regarding treatment, during the second period additional oxygen and ,2 agonists were used less, while the use of intravenous fluid-therapy and nebulized adrenaline increased. During the follow-up study made by phone interviews, 56.6% of the patients presented with a new wheezing episode after hospital discharge, 58.8% of them requiring healthcare assistance; these patients had a higher family history of asthma. Conclusions: even though the treatment of bronchiolitis has changed during these 5 years, main variations such as average hospital stay (5.2 days) and complications (intubations, referral to the ICU) did not have any significant modifications. It is also important to highlight the long term consequences of bronchiolitis derived from respiratory syncytial virus, because they can cause bronchial hypereactivity. A family history of asthma is considered a significant predictor of recurrent wheezing episodes.

Keywords : Bronchiolitis; Respiratory syncytial virus; Bronchial hyperreactivity; Family history.

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