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What's the Dx? Intercostal retractions, wheezing in child with congenital heart disease
HC Meissner - AAP News, 2012 - Am Acad Pediatrics A 9-month-old female is seen in the emergency department in February following four days of poor feeding and increased work of breathing. Physical examination reveals a temperature of 37.9 degrees Celsius (100.2 degrees Fahrenheit), pulse 167 beats per ...
Congenital heart disease occurs in four to eight children per 1,000 live births. Children with congenital heart disease who are most vulnerable to severe RSV infection include those younger than 2 years of age with surgically uncorrected lesions. This includes children with large left-to-right shunts, children with pulmonary hypertension that is greater than one-half the systemic pressure, infants with cyanotic heart disease and those with complex heart disease such as single ventricle anatomy.
A placebo-controlled trial demonstrated that palivizumab prophylaxis reduced the rate of RSV hospitalization by 45% among children with hemodynamically significant heart disease. Relative to the placebo arm, the reduction in RSV hospitalization was 29% for children with cyanotic disease and 58% for children with acyanotic heart disease. No placebo-controlled trial of any high-risk group of patients with palivizumab prophylaxis has demonstrated a statistically significant reduction in mortality rate.
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What's the Dx? Intercostal retractions, wheezing in child with congenital heart disease |
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