title: Paediatric apnoeas are not related to a specific respiratory virus, and parental reports predict hospitalisation.
abstract: OBJECTIVE
  The aim of this study was to determine the frequency of apnoeas in previously healthy young infants with acute respiratory tract infection (ARI) and correlate their occurrence with isolated micro-organisms, clinical findings, disease severity and outcome.
  
  
  METHODS
  We performed reverse transcriptase real-time polymerase chain reaction (RT-PCR) on the nasal wash specimens of a prospective cohort study of 582 children with ARI. Clinical data on a subgroup of 241 infants under three months of age, with and without apnoeas, were compared.
  
  
  RESULTS
  Our study found that 19 (7.9%) of the 241 infants under three months old had a history of apnoeas: eight had a respiratory syncytial virus (RSV), five had a different virus than RSV and seven RT-PCR results were negative. Infants with apnoeas were more likely to have cyanosis, had longer hospital stays and required extra oxygen for a longer period. Most patients with parental reported apnoeas also experienced apnoeas during hospitalisation.
  
  
  CONCLUSIONS
  This study observed apnoeas irrespective of the isolated micro-organism, and we hypothesise that they were related to the pathophysiology of the respiratory infection and not to the micro-organism itself. Parental reported apnoeas were a major warning sign and predicted that apnoeas would occur in hospital.
authors.affiliation: Department of Paediatrics, Reinier de Graaf Hospital, Delft, The Netherlands.
authors.forename: J O
authors.initials: JO
authors.lastname: Wishaupt
authors.affiliation: Department of Paediatrics, Reinier de Graaf Hospital, Delft, The Netherlands.
authors.forename: Ean
authors.initials: E
authors.lastname: van den Berg
authors.affiliation: Department of Paediatrics, Reinier de Graaf Hospital, Delft, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van Wijk
authors.affiliation: Pieter van Foreest Institute for Education and Research, Medical Centre Alkmaar, Alkmaar, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van der Ploeg
authors.affiliation: Department of Paediatrics, Groene Hart Ziekenhuis, Gouda, The Netherlands.|Department of Paediatrics, Ghent University Hospital, Ghent, Belgium.
authors.forename: F G A
authors.initials: FG
authors.lastname: Versteegh
authors.affiliation: Department of Paediatrics, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands.|Department of Infectious Diseases and Immunology, ErasmusMC-Sophia, Rotterdam, The Netherlands.
authors.forename: N G
authors.initials: NG
authors.lastname: Hartwig
mesh_terms: D000208:Acute Disease; D001049:Apnea / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy / Q000821:virology*; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D010290:Parents; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy / Q000821:virology; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014777:Virus Diseases / Q000150:complications* / Q000175:diagnosis / Q000628:therapy
keywords: Acute respiratory tract infection; Apnoea; Child; Respiratory arrest; Respiratory syncytial virus