Risk of respiratory syncytial virus in survivors with severe congenital diaphragmatic hernia.
BACKGROUND
During the follow-up period in surviving patients with severe congenital diaphragmatic hernia (CDH), respiratory complications, such as recurrence of CDH or chronic lung disease, have been reported to occur as a late complication. Although some risk factors for deterioration of respiratory condition have been reported in CDH, the risk of respiratory syncytial virus (RSV) in postoperative CDH patients has not as yet been reported upon.


METHODS
In 21 survivors with severe CDH, which had been detected antenatally, and whose lung:thoracic ratio was <0.2, the risk of RSV infection in those patients was investigated.


RESULTS
Five survivors with severe CDH had RSV infection and three patients needed hospitalization due to bronchiolitis during the follow-up period. In two patients the recurrence of CDH after the infection resulted in the need to perform a re-operation for CDH. All patients often suffered from chronic wheezing requiring medication after the first RSV infection.


CONCLUSIONS
RSV infection is a risk for deterioration of postoperative respiratory condition in severe CDH survivors. Considering the presence of pulmonary hypoplasia in severe CDH, the routine use of monoclonal antibody for RSV (palivizumab) might be effective for patients with severe CDH in the high season of RSV, similar to the patients with chronic lung disease, although further large multicenter studies are needed to clarify this hypothesis.
Masumoto
Kouji
K
Department of Pediatric Surgery, Graduate School of Medicine Sciences, Kyushu University, Fukuoka, Japan. kmasu@pedsurg.med.kyushu-u.ac.jp
Nagata
Kouji
K
Uesugi
Toru
T
Yamada
Tomomi
T
Kinjo
Tadamune
T
Hikino
Shunji
S
Hara
Toshiro
T
Taguchi
Tomoaki
T
D005260:Female; D006548:Hernia, Diaphragmatic / Q000150:complications* / Q000601:surgery; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012008:Recurrence; D018357:Respiratory Syncytial Virus Infections / Q000209:etiology*; D012307:Risk Factors