Table 2. Clinical Presentation and Course of Infants Admitted to the Intensive Care or High Acuity Unit With Respiratory Syncytial Virus Infection Stratified by Age Group in Months.
| Clinical presentation and course | Infants, No. (%) | P valuea | |||
|---|---|---|---|---|---|
| Total (N = 600) | 0-2 mos (n = 323) | 3-5 mos (n = 127) | 6-11 mos (n = 150) | ||
| Reason for admission | |||||
| LRTI | 594 (99.0) | 317 (98.1) | 127 (100.0) | 150 (100.0) | .04 |
| Apnea or bradycardia | 77 (12.8) | 67 (20.7) | 6 (4.7) | 4 (2.7) | <.001 |
| Cardiac arrest at home with CPR | 3 (0.5) | 3 (0.9) | 0 | 0 | .14 |
| CNS infection | 2 (0.3) | 2 (0.6) | 0 | 0 | .23 |
| Shock requiring vasopressors | 5 (0.8) | 3 (0.9) | 1 (0.8) | 1 (0.7) | .75 |
| Interventions within first 24 h | |||||
| Highest level of respiratory supportb | |||||
| None | 28 (4.7) | 16 (5.0) | 4 (3.1) | 8 (5.3) | .71 |
| Low-flow supplemental oxygen | 51 (8.5) | 30 (9.3) | 6 (4.7) | 15 (10.0) | .96 |
| High-flow nasal cannula oxygen | 252 (42.0) | 116 (35.9) | 71 (55.9) | 65 (43.3) | .03 |
| Continuous positive airway pressure | 52 (8.7) | 34 (10.5) | 7 (5.5) | 11 (7.3) | .18 |
| BiPAP/NIV | 114 (19.0) | 52 (16.1) | 24 (18.9) | 38 (25.3) | .02 |
| Invasive mechanical ventilation | 103 (17.2) | 75 (23.2) | 15 (11.8) | 13 (8.7) | <.001 |
| Cardiovascular support | 10 (1.7) | 6 (1.9) | 2 (1.6) | 2 (1.3) | .67 |
| Vasopressors | 6 (1.0) | 3 (0.9) | 1 (0.8) | 2 (1.3) | .72 |
| Clinical course | |||||
| Highest level of respiratory support | |||||
| None | 1 (0.2) | 1 (0.3) | 0 | 0 | >.99 |
| Low-flow supplemental oxygen | 11 (1.8) | 5 (1.5) | 1 (0.8) | 5 (3.3) | .30 |
| High-flow nasal cannula oxygen | 243 (40.5) | 114 (35.3) | 67 (52.8) | 62 (41.3) | .07 |
| Continuous positive airway pressure | 52 (8.7) | 33 (10.2) | 7 (5.5) | 12 (8.0) | .30 |
| BiPAP/NIV | 150 (25.0) | 69 (21.4) | 31 (24.4) | 50 (33.3) | .01 |
| Invasive mechanical ventilation | 143 (23.8) | 101 (31.3) | 21 (16.5) | 21 (14.0) | <.001 |
| Days ventilated, median (IQR) | 6 (4-10) | 6 (4-9) | 5 (3-10) | 7 (5-11) | .59 |
| Vasopressor-dependent shock | 27 (4.5) | 19 (5.9) | 3 (2.4) | 5 (3.3) | .15 |
| ECMO | 4 (0.7) | 2 (0.6) | 0 | 2 (1.3) | .53 |
| Days in ICU, median (IQR)c | 3 (2-7) | 4 (2-8) | 3 (2-5) | 3 (2-6) | .002 |
| Days in hospital, median (IQR)c | 5 (4-10) | 6 (4-12) | 5 (3-7) | 5 (3-8) | .001 |
| In-hospital death | 2 (0.3) | 0 | 0 | 2 (1.3) | .11 |
| Severity scores | |||||
| pSOFA score, median (IQR) | 4 (3-4) | 4 (3-5) | 3 (3-4) | 3 (3-4) | <.001 |
| PELOD-2 score, median (IQR) | 2 (1-4) | 2 (2-5) | 2 (0-4) | 0 (0-2) | <.001 |
| PARDS criteria met | 120 (20.0) | 72 (22.3) | 21 (16.5) | 27 (18.0) | .19 |
Abbreviations: BiPAP, bilevel positive airway pressure; CNS, central nervous system; CPR, cardiopulmonary resuscitation; ECMO, extracorporeal membrane oxygenation; ICU, intensive care unit; LRTI, lower respiratory tract infection; NIV, noninvasive ventilation; PARDS, pediatric acute respiratory distress syndrome; PELOD, pediatric logistic organ dysfunction; pSOFA, pediatric sequential organ failure assessment.
Fisher exact test performed if any expected cell count was less than 5.
Data displayed reflect responses to a question as to whether the infant received mechanical ventilation and/or oxygen support during the first 24 hours of hospital admission. Low-flow supplemental oxygen and invasive mechanical ventilation were also noted at admission if reported on day 1 of daily clinical variables. This information may reflect pre–pediatric intensive care unit care.
A total of 598 survivors.