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Observational Study
. 2018 Jun;177(6):913-920.
doi: 10.1007/s00431-018-3138-6. Epub 2018 Apr 13.

Characteristics of children admitted to intensive care with acute bronchiolitis

Marwa Ghazaly  1   2 , Simon Nadel  3   4
Affiliations
Observational Study

Characteristics of children admitted to intensive care with acute bronchiolitis

Marwa Ghazaly et al. Eur J Pediatr. 2018 Jun.

Abstract

To assess factors associated with outcome in children admitted to paediatric intensive care (PIC) with bronchiolitis. A retrospective study of children admitted to the PICU at St Mary's Hospital, London with bronchiolitis over a 6-year period (2011-2016). All bronchiolitis admissions < 2 years were included. Data collected particularly noted risk factors for severity, demographics, microbiology and outcome. We compared respiratory syncytial virus (RSV) with non-RSV status. Multivariate analysis was performed. Two hundred seventy-four patients were identified. Median age was 60 days (IQR 28-150 days), 63% were male, 90% were invasively ventilated and 42% were previously healthy. Pre-existing co-morbidities were present in 38%. The most frequently isolated pathogens were RSV (60%) and rhinovirus (26%). Co-infection was present in 45%, most commonly with RSV, rhinovirus and bacterial pathogens. Median length of stay (LOS) was 6 days (IQR 4.75-10). Younger age, prematurity, RSV, co-infection and co-morbidity were identified as significant risk factors for prolonged LOS. Six children died. Five of these had documented co-morbidities.

Conclusion: RSV causes more severe bronchiolitis than other viruses. Nearly half of children admitted to PICU with RSV were previously healthy. Current guidelines for immunoprophylaxis of RSV bronchiolitis should be re-considered. What is Known: • Bronchiolitis is one of the most common reasons for unplanned PICU admission. The most common virus causing bronchiolitis is RSV • Bronchiolitis severe enough to require admission to PICU is associated with frequent morbidity but has low mortality. What is New: • RSV causes more severe bronchiolitis than other viruses. • Nearly half of all children admitted to PICU with RSV were previously healthy.

Keywords: Bronchiolitis; Children; Co-morbidity; Intensive care; Outcome; RSV; Ventilation.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This study was discussed the with local Ethics committee, and they decided that ethical approval was not required due to the retrospective nature of the study and the fact that all subject data was anonymized.

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References

    1. Al-Ansari M, Lyall H NS (2013) Potentially preventable admissions to PICU due to RSV and Influenza. Poster Presentation. Paediatric Intensive Care Society UK Annual Meeting
    1. Ali A, Yousafzai MT, Waris R, Jafri F, Aziz F, Abbasi IN, et al. RSV associated hospitalizations in children in Karachi, Pakistan: implications for vaccine prevention strategies. J Med Virol. 2017;89(7):1151. doi: 10.1002/jmv.24768. - DOI - PMC - PubMed
    1. Birkhaug IM, Inchley CS, Aamodt G, Ånestad G, Nystad W, Nakstad B. Infectious burden of respiratory syncytial virus in relation to time of birth modifies the risk of lower respiratory tract infection in infancy. Pediatr Infect Dis J. 2013;32:e235–e241. doi: 10.1097/INF.0b013e31828ab9ff. - DOI - PubMed
    1. Bradley JP, Bacharier LB, Bonfiglio J, Schechtman KB, Strunk R, Storch G, et al. Severity of respiratory syncytial virus bronchiolitis is affected by cigarette smoke exposure and atopy. Pediatrics. 2005;115:7–14. doi: 10.1542/peds.2004-0059. - DOI - PubMed
    1. Brand HK, de Groot R, Galama JMD, Brouwer ML, Teuwen K, Hermans PWM, et al. Infection with multiple viruses is not associated with increased disease severity in children with bronchiolitis. Pediatr Pulmonol. 2012;47:393–400. doi: 10.1002/ppul.21552. - DOI - PMC - PubMed

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