Anales de Pediatría

Anales de Pediatría

Volume 63, Issue 4, October 2005, Pages 357-362
Anales de Pediatría

Asociación Española de Pediatría
Recomendaciones para la prevención de la infección por virus respiratorio sincitialRecommendations for the prevention of respiratory syncytial virus infections

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Los prematuros de 35 semanas o menos de gestación, con o sin enfermedad pulmonar crónica (EPC), y los lactantes con cardiopatía congénita grave tienen un mayor riesgo de infección y hospitalización por el virus respiratorio sincitial (VRS). Las medidas higiénicas y los anticuerpos monoclonales para el VRS son eficaces en la disminución de la hospitalización en estos pacientes. Su utilización: a) es muy recomendable en prematros de 28 semanas o menos de gestación al nacer, o nacidos entre las 29-32 semanas con menos de 6 meses al inicio de la estación del VRS o dados de alta durante la misma, o niños afectados de EPC en tratamiento en los últimos 6 meses, o de cardiopatía congénita grave. Los dos últimos grupos pueden recibir la profilaxis durante dos estaciones del VRS. b) Es recommendable en prematuros 32-35 semanas de gestación menores de 6 meses que presenten dos o más factores de riesgo: edad cronológica inferior a 10 semanas al comienzo de la estación VRS, lactancia materna de 2 meses o menos (por indicación médica), tener al menos un hermano de menos de 14 años, asistencia a guardería, antecedentes familiars de sibilancias, 4 personas o más adultas en el hogar o malformaciones de vías aéreas o enfermedad neuromuscular.

Premature babies ≤ 35 weeks gestation, with or without chronic lung disease (CLD), and infants affected by severe congenital heart disease should be considered high risk population for RSV infection and hospitalization. Hygienic measures and RSV monoclonal antibodies (palivizumab) have been found useful in decreasing rates of RSV hospitalization in these patients. Guidelines for their administration include: a) strongly recommended use in premature babies ≤ 28 weeks gestation, or born between 29-32 weeks gestation and less than 6 months at start of RSV station or discharged along it, or affected by CLD in treatment during last 6 months or by severe congenital heart disease. Last two groups could be prophylaxed for two RSV seasons. b) Recommended use among premature babies between 32-35 weeks gestation and less than 6 months of age and presenting two or more risk factors:chronologic age < 10 weeks at start of RSV station, breastfeeding ≤ 2 months (physician prescription), sibling < 14 years old, day-care assistance, family history of wheezing, ≥ 4 adults at home, airways malformation or neuromuscular disease.

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