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2018 ; 177
(6
): 913-920
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Characteristics of children admitted to intensive care with acute bronchiolitis
#MMPMID29654399
Ghazaly M
; Nadel S
Eur J Pediatr
2018[Jun]; 177
(6
): 913-920
PMID29654399
show ga
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.