A RETROSPECTIVE STUDY OF RESPIRATORY OUTC OME IN INFANTS WITH SEVERE BRONCHIOLITIS

Background. Respiratory syncytial virus (RSV) infection in infancy can induce bronchial reactivity and virus-specific IgE production; these responses may favor the later development of asthma. This retrospectiv e study examines the influences of early and severe forms of bronchiol itis on such an outcome. Population and methods. The files of 43 infan ts who had spent 1 to 24 days (mean 7.8 days) in intensive care betwee n 1986-1990 for severe bronchiolitis with apnea and/or hypercapnia and /or hypoxemia were studied. The parents of all these children agreed t o answer a standard questionnaire covering perinatal events, gestation al age, number and frequency of recurrent episodes of wheezing, person al and familial history of allergy and environmental conditions. 15 of the children were preterm and 12 of them were given respiratory suppo rt during the neonatal period; 5 of these patients developed broncho-p ulmonary dysplasia. RSV was isolated in 20 of 39 patients. Results. 26 of the 41 surviving patients developed at least 3 episodes of wheezin g over periods ranging from 5 to 54 months (mean 27.6 months): 15 of t hem were admitted at least once for asthma and 17 were given long-term bronchodilators and/or corticosteroids. Of the 8 patients with histor ies of allergy, 6 developed asthma, as did 7 of the 9 that had been in close contact with other children, and 9 of the 15 patients who had b een exposed to tobacco. Conclusions. Not only is the development of as thma associated with risk factors (RSV infection, bronchopulmonary dys plasia, history of allergy, close contact with other children and expo sure to tocacco) but the severity of the bronchiolitis per se is also correlated with this risk.