RISK-FACTORS FOR RESPIRATORY SYNCYTIAL VIRUS-ASSOCIATED APNEA

Respiratory syncytial virus (RSV) infections are characterized by uppe r or lower respiratory tract symptoms including bronchiolitis and pneu monia. Apnoea may be the first sign of disease in children with RSV in fection. The aims of this study were the identification of independent risk factors for RSV associated apnoea and the prediction of the risk for mechanical ventilation in children with RSV associated apnoea. Me dical records of children younger than 12 months of age admitted with RSV infection between 1992 and 1995 to the Sophia Children's Hospital, were reviewed. Demographic parameters, clinical features and laborato ry parameters (SaO(2), pCO(2) and pH) were obtained upon admission and during hospitalization. Children with and without apnoea were compare d using univariate and multivariate logistic and linear regression ana lysis. One hundred and eighty-five patients with RSV infection were ad mitted of whom 38 (21%) presented with apnoea, Patients with apnoea we re significantly younger, had a significantly lower temperature, highe r pCO(2) and lower pH and had on chest radiographs also more signs of atelectasis. The number of patients admitted to the ICU because of mec hanical ventilation and oxygen administration was significantly higher in children with RSV associated apnoea. Apnoea at admission was a str ong predictor for recurrent apnoea. The relative risk for mechanical v entilation increased with the number of episodes of apnoea: 2.4 (95% C I 0.8 - 6.6) in children with one episode of apnoea (at admission) ver sus 6.5 (95% CI 3.3 - 12.9) in children with recurrent episodes of apn oea. Conclusions Age below 2 months is the strongest independent risk factor for RSV associated apnoea, Apnoea at admission increases the ri sk for recurrent apnoea. The risk for mechanical ventilation significa ntly increases in children who suffer from recurrent apnoea.