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Pediatric Respiratory
Infections Impact
on Cardiopulmonary Indicators.
My name is Hannah
Bellsham-Revell and I'm
a consultant pediatric
cardiologist
at Evelina London
Children's Hospital.
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Viral versus
bacterial infections.
Most common illnesses
are viral but they
can develop secondary
bacterial infections.
For example, the common
cold or entero/rhinovirus,
RSV, flu, human
metapneumovirus, parainfluenza.
Each year tends to have a
predominant virus that you see.
Bacterial infections
are more common
in those underlying
conditions for example,
cystic fibrosis, or those
who are immunosuppressed.
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Impact on vital signs.
Minor viruses may just
produce a runny nose,
cough or coryza with
a low grade fever,
some minimal changes
to vital signs.
With fever, the heart and
respiratory rate will increase.
As children become more unwell
and start working harder,
respiratory and heart rate
will increase as well.
Oxygen saturations may be
lower in more
significant infections.
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Management of severe infections.
If there are signs of
a bacterial infection
so raised inflammatory markers,
chest X-ray changes, etc
then consider antibiotics.
Children may need a
nasogastric tube or
even IV fluids because
a distended stomach can
impact on ventilation.
Oxygen is usually used
as the first line
and then consider non invasive
support. For example,
Octiflow, Vapotherm, CPAP if
further support is needed.
If the patient is tiring or non
invasive or having
significant apneas
which are seen more
frequently in small babies
then they will need intubation
and mechanical ventilation.
If the patient is
on a ventilator,
they may need suctioning
for secretions and can have
targeted bronchoalveolar
lavage to look for infection.
Differentiating presentations.
