Can new laboratory parameters be added for clinical scoring systems to determine the severity of RSV bronchiolitis?

Abstract

Objectives In this study, the aim is to investigate the clinical findings as well as laboratory and echocardiographic differences in infants with respiratory syncytial virus (RSV) bronchiolitis hospitalized in the pediatric intensive care unit (PICU) compared to those hospitalized in the general pediatric ward and thus contribute to the establishment of a novel evidence-based medical scoring.Methods The study was conducted by retrospectively reviewing the files of 58 infants aged 1-12 months who were hospitalized in the PICU and general pediatric ward of Health Sciences University of Bursa City Hospital with a definite diagnosis of RSV bronchiolitis between September 2022 and April 2023.Results There were significant differences in clinical findings (Bronchiolitis Score of Sant Joan de D & eacute;u up arrow), laboratory tests [blood gas (pH down arrow-PaCO2 up arrow-lactate up arrow) and N-terminal pro-B-type natriuretic peptide (NT-proBNP up arrow)] and echocardiographic parameters [systolic pulmonary artery pressure (sPAP up arrow), right ventricular Tei index (RVTX up arrow), left ventricular systolic eccentricity index (LVEls up arrow) and tricuspid annular planar systolic excursion (TAPSE down arrow)] in infants hospitalized in PICU compared to those hospitalized in general pediatric ward. Multivariate regression analysis revealed that the best indicator to add to the clinical score in terms of PICU hospitalization was NT-ProBNP (OR: 1.007, 95 % CI 1.002-1.011, p=0.003).Conclusions The severity of RSV bronchiolitis can be evaluated more objectively with new scoring methods to be developed by adding laboratory and echocardiographic parameters, especially NT-proBNP, to clinical scoring systems.