Myocardial injury in children with respiratory syncytial virus infection

Paul A. Checchia, Heidi J. Appel, Stephen Kahn, Fredrick A. Smith, Stanford T Shulman, Elfriede Pahl, Harris P. Baden

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

Objective:Respiratory syncytial virus (RSV) infection is associated with a number of extrapulmonary manifestations, including a sepsis-like syndrome characterized by any combination of hypothermia, fever, apnea, hypovolemia, and myocardial dysfunction. We hypothesized that RSV can have a direct injurious effect on the myocardium of infants and children that can be detected by the presence of cardiac troponin I (cTnI), a highly sensitive and specific marker of myocardial injury, in the blood of patients infected with the virus. Design:Serial cTnI measurements were obtained from patients admitted with documented RSV infection to the pediatric intensive care unit (PICU). Participants:Data were collected and analyzed from 22 RSV infected patients and 11 control patients. Results:Elevated levels of cTnI were detected in 54.5% (12/22) of the study population during their PICU admission. The average cTnI level was significantly higher in the RSV infected group than in controls. There was a significant association between the presence of a positive troponin assay and the occurrence of a cardiovascular event, the need for inotropic support, and the requirement of mechanical ventilation. Patients who required inotropic support had a significantly higher cTnI level than the rest of the study population. Conclusion:A large percentage of children admitted to the PICU with RSV infection have myocardial damage as detected by the use of commercially available troponin assays. Additionally, in a portion of these patients, this damage is clinically significant, leading to cardiovascular instability and the need for inotropic support.

Original languageEnglish (US)
Pages (from-to)146-150
Number of pages5
JournalPediatric Critical Care Medicine
Volume1
Issue number2
StatePublished - Jan 1 2000

Keywords

  • myocardium
  • respiratory syncytial virus
  • troponin

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

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    Checchia, P. A., Appel, H. J., Kahn, S., Smith, F. A., Shulman, S. T., Pahl, E., & Baden, H. P. (2000). Myocardial injury in children with respiratory syncytial virus infection. Pediatric Critical Care Medicine, 1(2), 146-150.