PEDIATRICS Vol. 92 No. 4 October 1993, pp. 642
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RESPIRATORY SYNCYTIAL VIRUS MORBIDITY AND MORTALITY ESTIMATES IN CONGENITAL HEART DISEASE PATIENTS: A RECENT EXPERIENCE

J. F. L. MD

In conclusion, present respiratory syncytial virus mortality rates in pediatric patients with congenital heart disease are much less than those described nearly a decade ago. Patients with pulmonary hypertension have increased mortality rates as measured by duration of hospitalization, need for and duration of intensive care, and requirement and duration of mechanical ventilation. However, greatly increased mortality risk is not currently seen in congenital heart disease patients with pulmonary arterial hypertension compared with those congenital heart disease patients without this diagnosis. The substantially reduced mortality rate differences observed between the present congenital heart disease patients and patients of a decade ago are probably due to advances in pediatric intensive care medicine and surgical management of heart disease. It is unlikely that the availability of ribavirin alone has been responsible for the marked reduction in respiratory syncytial virus congenital heart disease mortality rates. Appropriately designed studies addressing efficacy, cost-effectiveness, and short- and long-term safety of ribavirin use in patients with congenital heart disease are still needed.