30Mar 2017

EFFECTIVENESS OF PALIVIZUMAB IN PREVENTING RSV HOSPITALIZATION IN HIGH RISK INFANTS WITH CHD &PREMATURE INFANTS.

  • CABP/FICMSP, Karballa Teaching Hospital for Pediatric, Karballa .Iraq.
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Respiratory syncytial virus (RSV) is the major cause of bronchiolitis and viral pneumonia in children younger than 1 yr of age. Infection with respiratory syncytial virus (RSV) is one of the major causes of childhood respiratory morbidity and hospitalization. Palivizumab, a humanized monoclonal antibody, has been recommended for high risk infants to prevent severe RSV-associated respiratory illness. Key ward:palvizumab +bronchiolitis+RSV A randomized clinical trial was done in Karballa Teaching Hospital For Pediatrics from October 2015-march 2017 to studies the protective effect of palivizumab prophylaxis for reducing RSV-associated hospitalizations in infants with congenital heart disease and premature infants. We studied 84 patients divided to 2 groups(group A&B) : 30 patients with congenital heart disease their age less than 1 year considered group A and 54 premature neonates who are delivered at the season of RSV(October –March) considered group B . Group A(30 patients) :subdivided to 2 subgroups: A1&A2,both had hemodynamically significant CHD(large VSD &PDA,complete AV canal with heart failure and on medical treatment,TOF and D-TGA ) . 18 patients who received 5 doses of palvizumab monthly(from October- March) considered as group A1and 12 patients who received 3 doses monthly considered as group A2,with monthly follow up for signs of any respiratory illness. Group B (54patients): subdivided to 2 subgroups:B1&B2 both were premature neonates their gestational age less than 35 weeks of gestation and their body weight less than 1500gm .25 patients they were received 5 doses of palvizumab monthly for 5 months from October-March considerd as group B1 and 25 patients they were received 3 doses of palvizumab monthly considered as groupB2. 2patients received 2 doses only and developed irritability &cough therefore we stopped palvizumab injection,2 patients received one dose and escape from follow up(therefore those 4 patients were excluded from the study). premature neonates with severe sepsis,severe jaundice,severe congenital malformation,history of birth asphyxia and complex congenital heart disease also were excluded from the study All 4 groups were received palvizumab 15mg/kg intramuscular monthly with regular follow up each months for any sign of respiratory distress. For each group we select control groupC1(30 patients with CHD)&group C2(50 premature infants) :they didn’t received palvizumab ,both groups were taken from cardiology clinic,outpatients clinic &premature department &compared with each group. The results for group A1, 3 patients developed mild bronchiolitis without hospitalization,for group A2 only one patient(8.33%) need hospitalization . The results for group B1, 7 of them they developed mild bronchiolitis and they didn’t need hospitalization,for groupB2, 8 of them they developed mild bronchiolitis and one of them(4%) need hospitalization for 2 weeks.no death was reported. Regarding control group: 30 patients with CHD(group C1) who didn’t received palvizumab,21(70%) patients they were need hospitalization &1 death was reported . and from 50 patients premature infants(group C2) ,39 patients(78%) developed bronchiolitis and they need admittion &4 death was reported. In this study we found breast feeding had significant factor that contribute to the reduction of severity of bronchiolitis and rate of hospitalization. From this study we recommend :the usage of palvizumab as prophylaxis against RSV for premature infants & hemodynamically significant CHD because its effectiveness in reduction of morbidity &mortality. And encourage breast feeding for its effectiveness against severe disease in infants below 1 year.

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[D. Eman Hassn Alhmairy. (2017); EFFECTIVENESS OF PALIVIZUMAB IN PREVENTING RSV HOSPITALIZATION IN HIGH RISK INFANTS WITH CHD &PREMATURE INFANTS. Int. J. of Adv. Res. 5 (Mar). 1583-1596] (ISSN 2320-5407). www.journalijar.com

Eman Hassn Alhmairy
specialist pediatric

DOI:

Article DOI: 10.21474/IJAR01/3667      
DOI URL: https://dx.doi.org/10.21474/IJAR01/3667

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