Abstract
Two infants with severe respiratory syncytial virus infection which resulted eventually in classical adult respiratory distress syndrome (ARDS) are presented. Both infants had severe apneic spells, necessitating intubation and mechanical ventilation (MV). Chest radiographs changed after a few days after institution of MV from initial bronchopneumonia like pattern to severe ARDS. Assessment of respiratory system mechanics (single breath occlusion technique) revealed severe restrictive disease in both cases. The first patient recovered with residual restrictive changes determined during a follow-up 2.5 months later, whereas the second infant died because of ARDS, pulmonary interstitial emphysema and hypoxemic hypoxia.
Key words: Infant respiratory syncytial virus, Adult respiratory distress syndrome, Respiratory system compliance and resistance
References
- 1.Denny FW, Clyde WA., Jr Acute lower respiratory tract infection in nonhospitalized children. J Pediatr. 1986;108:635–636. doi: 10.1016/S0022-3476(86)81034-4. [DOI] [PubMed] [Google Scholar]
- 2.Hall CB, Hall WJ, Gala CL, MaGill FB, Leddy JP. Longterm prospective study in children after respiratory syncytial virus infection. J Pediatr. 1984;105:358–364. doi: 10.1016/S0022-3476(84)80005-0. [DOI] [PubMed] [Google Scholar]
- 3.Pfenninger J, Gerber A, Tschaeppeler H, Zimmermann A. Adult respiratory distress sydnrome in children. J Pediatr. 1982;101:352–357. doi: 10.1016/S0022-3476(82)80057-7. [DOI] [PubMed] [Google Scholar]
- 4.Lesouef PN, England SJ, Bryan AC. Passive respiratory mechanics in newborns and children. Am Rev Respir Dis. 1984;129:552–556. [PubMed] [Google Scholar]
- 5.Pfenninger J, Aebi C, Bachmann D, Wagner BP. Lung mechanics and gas exchange in ventilated preterm infants during treatment of hyaline membrane disease with multiple doses of artificial surfactant (Exosurf) Pediatr Pumonol. 1992;14:10–15. doi: 10.1002/ppul.1950140104. [DOI] [PubMed] [Google Scholar]
- 6.Pfenninger J, Aebi C. Respiratory response to salbutamol (albuterol) in ventilator-dependent infants with chronic lung disease: pressurized aerosol delivery versus intravenous injection. Intensive Care Med. 1993;19:251–255. doi: 10.1007/BF01690544. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Bruhn F, Mokrohisky ST, McIntosh K. Apnea assoicated with respiratory syncytial virus infection in young infants. J Pediatr. 1977;90:382–386. doi: 10.1016/S0022-3476(77)80697-5. [DOI] [PubMed] [Google Scholar]
- 8.Debruin W, Notterman DA, Magid M, Godwin T, Johnston S. Acute hypoxemic respiratory failure in infants and children: Clinical and pathologic characteristics. Crit Care Med. 1992;20:1223–1234. doi: 10.1097/00003246-199209000-00008. [DOI] [PubMed] [Google Scholar]
- 9.Murray JF, Matthay MA, Luce JM, Flick MR. An expanded definition of the adult respiratory distress syndrome. Am Rev Respir Dis. 1988;138:720–723. doi: 10.1164/ajrccm/138.3.720. [DOI] [PubMed] [Google Scholar]
- 10.Stretton M, Deakers TW, Newth CJL. Spirometry, lung volumes, flows and mechanics in the acute phase of ARDS in pediatric patients. Am Rev Respir Dis. 1991;143:A127–A127. [Google Scholar]
- 11.Fanconi S, Kraemer R, Weber J, Tschaeppeler H, Pfenninger J. Longterm sequelae in children surviving adult respiratory distress syndrome. J Pediatr. 1985;106:218–222. doi: 10.1016/S0022-3476(85)80290-0. [DOI] [PubMed] [Google Scholar]
- 12.Pollack MM. An RSVP to RSV (respiratory syncytical virus): declining mortality rates. Crit Care Med. 1992;20:1375–1376. doi: 10.1097/00003246-199210000-00003. [DOI] [PubMed] [Google Scholar]
- 13.Moler FW, Custer JR, Bartlett RH, Palmisano J, Meliones JN, Delius RE, Braden EI, Snedecor S. Extracorporeal life support for pediatric respiratory failure. Crit Care Med. 1992;20:1112–1118. doi: 10.1097/00003246-199208000-00008. [DOI] [PubMed] [Google Scholar]
