Clinical and Laboratory ObservationAirway eicosanoids in acute severe respiratory syncytial virus bronchiolitis☆
Section snippets
Population characteristics
This prospective study was conducted between December 1, 1999, and April 30, 2000, in the PICU at Sainte-Justine Hospital. All infants younger than aged 2 years who required intubation for bronchiolitis were considered eligible. The control group was composed of healthy infants with no respiratory symptoms who were intubated for elective surgery. This study was approved by the Scientific and the Ethics Committee at Sainte-Justine Hospital.
Inclusion criteria for bronchiolitis population
Inclusion criteria were: (1) first episode of
Results
Fourteen children with RSV bronchiolitis and 14 controls constituted the two groups. There were no differences for sex, weight, age, and history of atopy or prematurity (Table). To confirm the severity of the disease, pediatric clinical scores (Pediatric Risk of Mortality Scale II [PRISM] scores [9] and Respiratory Distress Assessment Instrument [RDAI] scores [5]) were calculated.
The study population had severe bronchiolitis, were all intubated (for a mean of 6.3 days), and had an increased
Discussion
A variety of eicosanoids representing distinct pathways were measured in ET secretions collected from infants intubated for RSV bronchiolitis and were compared with those of children intubated for elective surgery. Cysteinyl LT and LTB4 from the 5-lipoxygenase pathway and PGE2 from the cyclooxygenase pathway were increased in infants with bronchiolitis. In contrast, 15 HETE from the 15-lipoxygenase pathway, the major eicosanoid found in normal lung fluids, was not elevated in children with RSV.
Acknowledgements
We thank Dr Francois Proulx and Dr Barbara Mazer for their help with the statistical analysis.
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Yves Sznajer is supported by a Grant from the Scientific Foundation A. Loicq.
Bruce Mazer, Marisa Tucci and Baruch Toledano are supported by the Fonds de la Recherche en Santé du Québec