RSV as a cause of ARDS

Ghazaly MMH, Faddan NHA, Raafat DM, Mohammed NA, Nadel S

Sepsis, trauma, burn, and transfusion related lung injury are known causes of pediatric ARDS, an alveolar disease leading to hypoxemia. Viral respiratory infection has been mentioned as a more rare cause of ARDS, but the role of individual viruses, such as RSV, is understudied. This single-center retrospective observational study shows that acute viral bronchilitis is an important cause of pediatric acute respiratory distress syndrome in children under the age of 2 years. Among 144 children admitted to the PICU with acute viral bronchiolitis, 27% developed acute respiratory distress syndrome. In half of these cases (51%) RSV was found as the triggering pathogen of disease. Bacterial coinfection was a significant risk factor for the development of acute respiratory distress syndrome in children with acute viral bronchiolitis. This study confirms that RSV respiratory infection, commonly considered a disease of the distal respiratory tract, often extends to the alveoli, thereby compromising oxygenation.