Rhinovirus Detection in the Nasopharynx of Children Undergoing Cardiac Surgery Is Not Associated With Longer PICU Length of Stay: Results of the Impact of Rhinovirus Infection After Cardiac Surgery in Kids (RISK) Study.

Autor:	Roeleveld PP; Department of Pediatric Intensive Care, Leiden University Medical Center, Leiden, The Netherlands., Van Rijn AL; Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands., de Wilde RBP; Department of Pediatric Intensive Care, Leiden University Medical Center, Leiden, The Netherlands., van Zwet EW; Department of Statistics, Leiden University Medical Center, Leiden, The Netherlands., Wink J; Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands., Rozendaal L; Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands., Hogenbirk K; Department of Pediatric Intensive Care, Leiden University Medical Center, Leiden, The Netherlands., Hazekamp MG; Department of Thoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands., Man WH; Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands., Sidorov I; Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands., Kraakman MEM; Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands., Claas ECJ; Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands., de Jonge E; Department of Intensive Care, Leiden University Medical Center, Leiden, The Netherlands., Kroes ACM; Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands., de Vries JJC; Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands.
Jazyk:	angličtina
Zdroj:	Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies [Pediatr Crit Care Med] 2021 Jan 01; Vol. 22 (1), pp. e79-e90.
DOI:	10.1097/PCC.0000000000002522
Abstrakt:	Objectives: To determine whether children with asymptomatic carriage of rhinovirus in the nasopharynx before elective cardiac surgery have an increased risk of prolonged PICU length of stay. Study Design: Prospective, single-center, blinded observational cohort study. Setting: PICU in a tertiary hospital in The Netherlands. Patients: Children under 12 years old undergoing elective cardiac surgery were enrolled in the study after informed consent of the parents/guardians. Interventions: The parents/guardians filled out a questionnaire regarding respiratory symptoms. On the day of the operation, a nasopharyngeal swab was obtained. Clinical data were collected during PICU admission, and PICU/hospital length of stay were reported. If a patient was still intubated 3 days after operation, an additional nasopharyngeal swab was collected. Nasopharyngeal swabs were tested for rhinovirus and other respiratory viruses with polymerase chain reaction. Measurements and Main Results: Of the 163 included children, 74 (45%) tested rhinovirus positive. Rhinovirus-positive patients did not have a prolonged PICU length of stay (median 2 d each; p = 0.257). Rhinovirus-positive patients had a significantly shorter median hospital length of stay compared with rhinovirus-negative patients (8 vs 9 d, respectively; p = 0.006). Overall, 97 of the patients (60%) tested positive for one or more respiratory virus. Virus-positive patients had significantly shorter PICU and hospital length of stay, ventilatory support, and nonmechanical ventilation. Virus-negative patients had respiratory symptoms suspected for a respiratory infection more often. In 31% of the children, the parents reported mild upper respiratory complaints a day prior to the cardiac surgery, this was associated with postextubation stridor, but no other clinical outcome measures. Conclusions: Preoperative rhinovirus polymerase chain reaction positivity is not associated with prolonged PICU length of stay. Our findings do not support the use of routine polymerase chain reaction testing for respiratory viruses in asymptomatic children admitted for elective cardiac surgery. Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2020 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.)
Databáze:	MEDLINE
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