Ventricular Arrhythmia Associated with Respiratory Syncytial Viral Infection

Huang, Manxiang; Bigos, David; Levine, M. M.

doi:10.1007/s002469900369

Cited by 38 publications

(17 citation statements)

References 11 publications

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“…Ventricular fibrillation developed after an attempt at overdrive pacing [10]. Another case of ventricular tachycardia requiring cardioversion was reported subsequently [11]. Another life-threatening complication can be cardiac tamponade evolving from pericardial effusion [10,12].…”

Section: Resultsmentioning

confidence: 99%

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Eisenhut

2006

Crit Care

169

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IntroductionRespiratory syncytial virus (RSV) bronchiolitis is the most important cause for admission to the paediatric intensive care unit in infants with lower respiratory tract infection. In recent years the importance of extrapulmonary manifestations of RSV infection has become evident. This systematic review aimed at summarizing the available evidence on manifestations of RSV infection outside the respiratory tract, their causes and the changes in clinical management required.MethodsDatabases searched were Medline (1950 to present), EMBASE (1974 to present), PubMed and reference lists of relevant articles. Summarized were the findings of articles reporting on manifestations of RSV infection outside the respiratory tract in patients of all age groups.ResultsExtrapulmonary manifestations reported in previous observational studies included cardiovascular failure with hypotension and inotrope requirements associated with myocardial damage as evident from elevated cardiac troponin levels (35–54% of ventilated infants), cardiac arrhythmias like supraventricular tachycardias and ventricular tachycardias, central apnoeas (16–21% of admissions), focal and generalized seizures, focal neurological abnormalities, hyponatraemia (33%) associated with increased antidiuretic hormone secretion, and hepatitis (46–49% of ventilated infants). RSV or its genetic material have been isolated from cerebrospinal fluid, myocardium, liver and peripheral blood.ConclusionThe data summarized indicate a systemic dissemination of RSV during severe disease. Cerebral and myocardial involvement may explain the association of RSV with some cases of sudden infant death. In infants with severe RSV infection cardiac rhythm, blood pressure and serum sodium need to be monitored and supportive treatment including fluid management adjusted accordingly.

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Section: Resultsmentioning

confidence: 99%

Untitled

Eisenhut

2006

Crit Care

169

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“…Of these, 5 infants were recruited from the MICU, 6 were recruited from the ICP, and 4 from the Inpatient Units. There were 10 males and 5 females with a median age of 2.0 (0.4-18) months, median weight of 5.8 (3)(4)(5)(6)(7)(8)(9)(10)(11) kg and median height of 60 (50-84) cm. Median time to acute stabilization was 4 (1-6) days, time between initial and final CO recording was 2.5 (0.8-7.2) days and length of hospitalization was 3.6 (1.6-8.9) days.…”

Section: Resultsmentioning

confidence: 99%

“…In most cases these infants are admitted to the hospital for respiratory distress and hypoxia; however, RSV has been reported to produce myocarditis [2] or is associated with myocardial injury [3], arrhythmias [4,5], and viral-induced sepsis [6]. Infants with respiratory insufficiency from bronchiolitis may have similar clinical features to infants with congestive heart failure [7], presenting with irritability, fever, tachypnea, tachycardia and a mottled appearance.…”

Section: Introductionmentioning

confidence: 95%

Changes in cardiac output and stroke volume as measured by non-invasive CO monitoring in infants with RSV bronchiolitis

Caplow

McBride

Steil

et al. 2012

J Clin Monit Comput

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“…RSV infection accounts for between 70,000 and 120,000 hospitalizations in the United States of infants under 6 months of age and~70% of hospitalizations due to bronchiolitis [2][3][4][5]. Severe RSV infection has been associated with long-term effects such as asthma and wheezing and can cause significant mortality in high-risk groups, such as premature infants or children with immunodeficiency, chronic pulmonary disease, or cardiovascular disease [6][7][8][9]. In addition, RSV infection is a serious complication in immunocompromised subjects, particularly bone marrow transplant patients, and the elderly [10].…”

Section: Respiratory Syncytial Virusmentioning

confidence: 99%

Live Attenuated Vaccines for Respiratory Syncytial Virus

Teng

2010

Replicating Vaccines

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In the five decades since the identification of respiratory syncytial virus (RSV) as an important pediatric pathogen, no effective vaccine has been developed. Previous attempts to develop inactivated RSV vaccines resulted in vaccineenhanced disease, resulting in a greater focus on the generation of live attenuated RSV vaccines. However, identifying a live attenuated vaccine candidate that is appropriately attenuated and sufficiently immunogenic has proven to be difficult. Recently, reverse genetics systems have been developed for RSV, allowing researchers to introduce specific mutations into the genomes of recombinant vaccine candidates. These systems provide a means of determining the effects of known attenuating mutations and identifying novel methods of attenuating the virus without decreasing immunogenicity. In addition, different mutations can be combined in a single genome to fine-tune the level of attenuation and immunogenicity to achieve the proper balance in a viable vaccine candidate. Current research into RSV attenuation includes investigation of point mutations responsible for temperature sensitivity, nontemperature-sensitive attenuating mutations, and deletion of nonessential viral genes that play roles in viral RNA synthesis and/or inhibition of innate immune responses. Development of an effective RSV vaccine will likely rely on using reverse genetics systems to optimize the attenuation and immunogenicity of a live vaccine candidate, while preserving viral replication in vitro.

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Ventricular Arrhythmia Associated with Respiratory Syncytial Viral Infection

Cited by 38 publications

References 11 publications

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Changes in cardiac output and stroke volume as measured by non-invasive CO monitoring in infants with RSV bronchiolitis

Live Attenuated Vaccines for Respiratory Syncytial Virus

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