Right and left ventricular function in hospitalized children with respiratory syncytial virus infection

Abstract

Background

Extrapulmonary manifestations including cardiac dysfunction have been demonstrated in children with respiratory syncytial virus (RSV) infection requiring intensive care. The aim of this study was to examine cardiac function in hospitalized children with moderate RSV infection admitted to a regular pediatric ward.

Methods

We used echocardiography to determine cardiac output, and right and left ventricular function in 26 patients (aged 2 weeks to 24 months) with RSV infection. The echocardiographic results were compared with s-troponin, the need for supplementary oxygen or noninvasive respiratory support, and capillary refill time.

Results

The number of measured s-troponins (ten [38%] of the included children) was too low to assess differences between children with elevated levels and those with normal levels. There were no differences in cardiac function between patients receiving oxygen treatment or respiratory support and those who did not. Capillary refill time did not correlate with any of the echocardiographic parameters. Both left and right ventricular output (mL/kg/min) was higher than published reference values. All other echocardiographic parameters were within the reference range.

Conclusion

Children with moderate RSV infection had an increased left and right ventricular output, and cardiac function was well maintained. We conclude that routine cardiac ultrasound is not warranted in children with moderate RSV infection. The role of an elevated s-troponin in these patients remains to be determined.

Keywords:

• bronchiolitis
• capillary refill time
• child
• echocardiography
• respiratory syncytial virus

Acknowledgments

The authors thank the Hospital Research Foundation of Akershus University Hospital for sponsoring the study, and the participating children and their parents. They thank Eirik Nestaas and Per Arnesen for technical assistance and valuable advice, and Njål Kinne and Ole Frederik Zimmer for their support. The funding body had no role in the design of the study, or the collection, analysis, and interpretation of data, or in writing the manuscript.

Author contributions

TH, OA, and ALS contributed to concept and design, acquisition of data, analysis and interpretation of data, drafting the article and revising it critically for important intellectual content, and final approval of the version as submitted. BN contributed to concept and design, analysis and interpretation of data, revising the article critically for important intellectual content, and final approval of the version as submitted.

Disclosure

The authors report no conflicts of interest in this work.