Chest radiological patterns predict the duration of mechanical ventilation in children with RSV infection
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RSV-infected children demonstrate various radiographic features, some of which are associated with worse clinical outcomes.
To investigate whether specific chest radiological patterns in RSV-infected children with acute respiratory failure (ARF) in the peri-intubation period are associated with prolonged duration of mechanical ventilation.
Materials and methods
We included RSV-infected children <1 year of age admitted with ARF from 1996 through 2002 to the pediatric intensive care unit at Massachusetts General Hospital. Their chest radiographs were evaluated at three time-points: preintubation (day −1) and days 1 and 2 after intubation. Univariate and multiple logistic regressions models were utilized to investigate our objective.
The study included 46 children. Using day 1 chest radiograph findings to predict duration of mechanical ventilation of >8 days, a backward stepwise regression arrived at a model that included age and right and left lung atelectasis. Using day 2 chest radiograph results, the best model included age and left lung atelectasis. A model combining the two days’ findings yielded an area under the ROC curve of 0.92 with a satisfactory fit (P = 0.95).
Chest radiological patterns around the time of intubation can identify children with RSV-associated ARF who would require prolonged mechanical ventilation.
- Chest radiological patterns predict the duration of mechanical ventilation in children with RSV infection
Volume 39, Issue 2 , pp 117-123
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- Print ISSN
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- RSV infection
- Pediatric ICU
- Mechanical ventilation
- Chest radiograph
- Industry Sectors
- Author Affiliations
- 1. Division of Pediatric Critical Care and Cardiology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- 2. Division of Pediatric Radiology, Massachusetts General Hospital, Boston, MA, USA
- 3. Division of Pediatric Critical Care, Mattel Children’s Hospital at UCLA, Los Angeles, CA, USA
- 4. Pediatric Critical Care Unit, Shaarei Tzedek Medical Center, Jerusalem, Israel
- 5. Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- 6. Pediatric Critical Care Medicine, Massachusetts General Hospital, 175 Cambridge Street (#524), Boston, MA, 02114, USA