• An Pediatr (Barc) · Jun 2011

    [Severe bronchiolitis. Changes in epidemiology and respiratory support].

    • G Oñoro, E Pérez Suárez, M I Iglesias Bouzas, A Serrano, A Martínez De Azagra, M A García-Teresa, and J Casado Flores.
    • Servicio de Cuidados Intensivos Pediátricos, Hospital Infantil Universitario Niño Jesús, Madrid, Spain. gonorootero@hotmail.com
    • An Pediatr (Barc). 2011 Jun 1;74(6):371-6.

    IntroductionBronchiolitis generates lots of admissions during the cold months in the paediatric intensive care units (PICU). New forms of respiratory support are being used and could improve the care of these patients.ObjectivesTo analyse the epidemiological and respiratory support changes of children admitted to the PICU.Patients And MethodsAn observational, retrospective, descriptive and analytical study of patients with the diagnosis of bronchiolitis admitted to the PICU of a tertiary hospital during the respiratory syncytial virus (RSV) epidemic months between 2005 and 2010.ResultsA total of 229 patients were admitted, of whom 83% were infected with RSV. The mean age was 1.48 months, with children under 3 months being the greatest number of admissions (73.3%). December was the month with the highest number of admissions (52%). Mortality was 0.9%. The mean time of stay in the PICU and on respiratory assistance were 4 and 3 days, respectively (no significant differences between the periods studied). Patients with RSV bronchiolitis were younger than the negative RSV (mean 2.61 months and 4.05 months, P=.023). Active respiratory support was required in 73% of cases. The percentage of patients who required active respiratory support increased over the years (Z=3.81, P=.00014), especially high flow nasal oxygen therapy (Z=3.62, P=.00028). An inverse relationship was observed between patient age and length of stay in PICU (Beta=-0.245, P ≤.0001) and days on respiratory support (Beta=-0.167, P=.039).ConclusionsMost patients admitted to the PICU are less than 3 months old. Mortality was 0.9%. Respiratory support (especially non-invasive mechanical ventilation and high flow nasal oxygen therapy) is used increasingly often. The youngest patients need more days in PICU and more respiratory support.Copyright © 2010 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

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