ABSTRACT
OBJECTIVE: To evaluate the role of Doppler ultrasonography in the assessment of splanchnic circulation's hemodynamic changes in septic preterms at risk of necrotizing enterocolitis. METHODS: A total of 51 septic preterms were divided into two groups: 25 preterms with clinical signs of necrotizing enterocolitis (NEC) and 26 preterms with no clinical signs of NEC. Both groups were assessed with Doppler ultrasonography of the celiac and superior mesenteric arteries, and each septic preterm's peak systolic velocity (PSV), end-diastolic velocity (EDV), resistivity index (RI), and pulsatility index (PI) was calculated and recorded. RESULTS: These included a statistically significant lower PSV (p: 0.001) and a lower EDV (p: 0.001) in the superior mesenteric artery in the septic group with clinical signs of NEC in comparison with the septic group with no clinical signs of NEC. A statistically significant (p < 0.001) higher PSV celiac (CA)/PSV superior mesenteric (SMA) ratio was found for the group of septic preterms with clinical signs of NEC when compared to the other group. CONCLUSION: The study results showed that Doppler ultrasonography of the splanchnic circulation can be a tool for the early identification of NEC cases among septic preterms.
Subject(s)
Enterocolitis, Necrotizing/diagnostic imaging , Infant, Premature , Neonatal Sepsis/diagnostic imaging , Splanchnic Circulation , Ultrasonography, Doppler/methods , Biomarkers/blood , Blood Flow Velocity , Celiac Artery/diagnostic imaging , Celiac Artery/physiopathology , Cross-Sectional Studies , Enterocolitis, Necrotizing/physiopathology , Fatal Outcome , Female , Humans , Infant, Newborn , Intensive Care Units, Neonatal , Male , Mesenteric Artery, Superior/diagnostic imaging , Mesenteric Artery, Superior/physiopathology , Neonatal Sepsis/physiopathology , Prospective Studies , Pulsatile Flow , Radiography, AbdominalABSTRACT
BACKGROUND AND AIM: Respiratory syncytial virus (RSV) is one of the most important causes of acute lower respiratory tract infections (ALRTI) in infants and young children. This study was conducted to describe the epidemiology of ALRTI associated with RSV among children ≤ 5 years old in Egypt. PATIENTS AND METHODS: We enrolled 427 children ≤ 5 years old diagnosed with ALRTI attending the outpatient clinic or Emergency Department (ED) of Children Hospital, Cairo University during a one- year period. Nasopharyngeal aspirates were obtained from the patients, kept on ice and processed within 2 hours of collection. Immunoflourescent assay (IFA) for RSV was performed. RESULTS: 91 cases (21.3%) had viral etiology with RSV antigens detected in 70 cases (16.4%). The RSV positive cases were significantly younger than other non-RSV cases (mean age 8.2 months versus 14.2 months, p <0.001). RSV cases had significantly higher respiratory rate in the age group between 2-11 months (mean 58.4 versus 52.7/minute, p < 0.001) and no significant difference in the mean respiratory rate in the age group between 12-59 months. More RSV cases required supplemental oxygen (46% versus 23.5%, p < 0.001) with higher rate of hospitalization (37.1% versus 11.2%, p < 0.001) than the non-RSV cases. 97% of RSV cases occurred in winter season (p < 0.001). CONCLUSION: RSV is the most common viral etiology of ALRTI in children below 5 years of age, especially in young infants below 6 months of age. It is more prevalent in winter and tends to cause severe infection.