Does Bacterial Pneumonia Have Long-Term Effects in Children?

In previously healthy infants, bacterial pneumonia predicts ongoing chronic pulmonary dysfunction (CPD), according to results of a new study presented at the American Thoracic Society’s 2019 International Conference.

Results of the study were presented by lead researcher Garrett Keim, MD, from the Children’s Hospital of Philadelphia, on Sunday, May 19.

Acute respiratory failure is a common reason for admission to the pediatric intensive care unit. However, the short- and long-term effects on pulmonary health are unknown.

To better understand these effects, Dr Keim and colleagues prospectively recruited 255 previously healthy patients aged younger than 2 years who required mechanical ventilation for acute respiratory failure at multiple centers in the United States.

Patients were included in the analysis if they had extensive recording of their pediatric intensive care unit stay and hospital course.

Pulmonary dysfunction at discharge was defined as needing mechanical ventilation, supplemental oxygen, or bronchodilators/steroids at 28 days or hospital discharge.

Follow-up at 6 and 12 months screened for ongoing CPD, which was defined as having a respiratory PedsQL score of 5 or more or being diagnosed with asthma, requiring bronchodilator or inhaled steroids, or having an unscheduled clinical evaluation for respiratory symptoms.

At hospital discharge, 87 of the 255 participants had pulmonary dysfunction. After analyzing the data, the researchers found that positive bacterial respiratory culture strongly predicted pulmonary dysfunction at discharge. Nadir oxygenation index also predicted pulmonary dysfunction at discharge.

After 6 months, 66 of the 158 participants with follow-up data had CPD. After 12 months, 57 of the 158 participants had CPD.

“In previously healthy infants, following an episode of [acute respiratory failure] requiring [mechanical ventilation], development of CPD is common,” the researchers concluded.

“Positive bacterial respiratory culture was associated with ongoing CPD to at least 12-month follow-up. [Pulmonary dysfunction at discharge] predicted CPD at 6 months, which in turn was strongly associated with continued CPD at 12 months.”

—Amanda Balbi

Reference:

Keim G, Yehya N, Spear D, et al. Bacterial pneumonia predicts ongoing chronic pulmonary dysfunction in previously healthy infants. Paper presented at: ATS International Conference; May 17-22, 2019; Dallas, TX. https://www.abstractsonline.com/pp8/#!/5789/presentation/15652