Retrospective Multicenter Study of Respiratory Syncytial Virus Prophylaxis in Korean Children with Congenital Heart Diseases

Kim, Ah Young; Jung, Se Yong; Choi, Jae Young; Kim, Gi Beom; Kim, Young-Hwue; Shim, Woo Sup; Kang, I-Seok; Jung, Jo Won

The majority of CHD patients in this study (35.6%) had shunt lesions with pulmonary hypertension, and 94.8% had undergone corrective surgery. Because the Korean guideline for the use of palivizumab in infants with CHD limits the vaccination to the infants who are receiving medication for congestive heart failure, patients who showed improvement of heart failure after cardiovascular surgery usually had terminated medication, and therefore, were not eligible for additional vaccinations. Moreover, RSV pneumonia is associated with a high risk of postoperative complications. 4)26) 27) In this study, there were 5 deaths related to RSV infection; of these, underlying heart diseases for 3 among the 5 deaths were associated with simple left-right shunt lesion. The American Association of Pediatricians has recommended administration of another injection of palivizumab (15 mg/kg) as soon as possible in postoperative patients because serum palivizumab levels decrease by 58% after cardiopulmonary bypass. 15)16)28) Therefore, it is essential to supplement this guideline, as well as adhere to the existing guideline, ensuring that treatment is started at the right time and that an additional postoperative injection is given immediately. The emphasis should be the identification of children with CHD.