For children, this cold and flu season has hit early and hard. There has been an early explosion of respiratory virus infections in the US including RSV, rhinovirus, influenza and COVID.

RSV infection can lead to  airway changes including cellular changes resulting in large increases in mucus, debris and swelling. Physician Jonathan Temte recently pointed out in a practice update that as the diameter of the airways decrease the resistance to airflow increases exponentially (“[Airflow] resistance is proportional to the inverse of the radius of the [airway]  raised to the 4th power”]. The proportional reduction in  a small child is far greater than that in an adult, resulting in an increase in airflow resistance more than 5x compared to 1.5x in an adult.

Temte points out that complicating factors increase risk risks in children even further:

“Adding to this dilemma in infants are the following:

  • dry autumnal and winter air leads to thickened and harder to clear mucus
  • reluctance to suspend breathing to eat and drink results in less intake
  • dehydration produces even more hard to clear mucus
  • energy stores, needed to maintain the significant work of breathing, decrease
  • running out of fuel can lead to respiratory collapse.

Hydration, feeding, and humidification of air are all important for initial care of infants with RSV.  Close observation is essential, with early evaluation should respiration become labored.  Hospital care is largely supportive, but necessary in severe cases.  For eligible, high-risk children palivizumab can lower the risk of hospitalization.”

CDC Health Advisory RSV: click here.

Temte’s Practice Update: https://www.practiceupdate.com/c/144726/1/6/?elsca1=emc_enews_expert-insight&elsca2=email&elsca3=practiceupdate_primary&elsca4=primarycare&elsca5=newsletter&rid=NTU2MjE3OTMzOTkS1&lid=20849326

Updated AAP Guidance on RSV: https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/interim-guidance-for-use-of-palivizumab-prophylaxis-to-prevent-hospitalization/

Girards Law Firm helps those who have been injured by the failure to adhere to recognized best practices and standards of care. If your child has been injured please call for a free consultation at 214-346-9529

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