We aimed to delineate cardiopulmonary interactions in acute bronchiolitis and to evaluate the capacity of a combined cardiopulmonary ultrasonography to predict the need for respiratory support. This was a prospective observational single-center study that includes infants <12 month of age admitted to a hospital due to acute bronchiolitis. All the included patients underwent clinical, laboratory and cardiopulmonary ultrasonographic evaluation at the same time point within 24 h of hospital admission. The existence of significant correlation between cardiac and respiratory parameters was the primary outcome. The association of different cardiopulmonary variables with the need of respiratory support higher than O2, the length of stay hospitalization, the PICU stay and the duration of respiratory support were a secondary outcome. We enrolled 112 infants (median age 1 (0.5–3) months; 62% males) hospitalized with acute bronchiolitis. Increased values of the pulmonary variables (BROSJOD score, pCO2 and LUS) showed moderate correlations with NT-proBNP and all echocardiographic parameters indicative of pulmonary hypertension and myocardial dysfunction (Tei index). Up to 36 (32%) infants required respiratory support during the hospitalization. This group presented with higher lung ultrasound score (p < 0.001) and increased values of NT-proBNP (p < 0.001), the Tei index (p < 0.001) and pulmonary artery pressures (p < 0.001). All the analyzed respiratory and cardiac variables showed moderate-to-strong correlations with the LOS of hospitalization and the time of respiratory support. Lung ultrasound and echocardiography showed a moderate-to-strong predictive accuracy for the need of respiratory support in the ROC analysis, with the AUC varying from 0.74 to 0.87. Those cases of bronchiolitis with a worse pulmonary status presented with a more impaired cardiac status. Cardiopulmonary ultrasonography could be a useful tool to easily identify high-risk populations for complicated acute bronchiolitis hospitalization.

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Background and Objectives: Accurate and readily available biomarkers to predict the clinical course of bronchiolitis would enable enhanced decision-making in this setting. We explored the relationship of several biochemical parameters available at the pediatric emergency care setting with the need of advanced respiratory support (ARS): continuous positive airway pressure (CPAP), biphasic positive airway pressure (BiPAP), or invasive mechanical ventilation (MV) in bronchiolitis.Methods: Single-center, prospective, observational, including infants aged less than 12 months diagnosed with acute bronchiolitis at the Pediatric Emergency Department. Determination of plasmatic values of several laboratory tests was performed at the time of hospital admission. Multivariate logistic analysis identified independent predictors for need of ARS.Results: From October 1, 2018 to May 1, 2020, we recruited 149 infants (58% males; median age of 1 [0.5-2.5] month). Thirty-seven (25%) cases required ARS.After adjusting by age, bacterial superinfection, and comorbidities in the multivariate analysis, only higher levels of glycemia (p = 0.001), C-reactive protein (CRP) (p = 0.028), CRP/albumin ratio (p = 0.032), and NT-proBNP (p = 0.001) remained independently associated with ARS. These biomarkers reached moderate prediction accuracy with area under the curve of receiver operator curve curves ranging from 0.701 to 0.830 (p = 0.001). All they presented relatively high specificity (0.75-0.84) and negative predictive values (0.77-0.89) with low sensitivity and positive predictive values. They also correlated significantly with length of stay hospitalization (p = 0.001). Conclusion:Increased plasmatic levels of CRP, CRP/albumin ratio, glycemia, and NT-proBNP at hospital admission are associated with the need for ARS in infants with acute bronchiolitis.

This is the first report of PSVT as an adverse reaction to DEX in a paediatric patient without heart disease.

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Background and aims The advantages of breastfeeding are largely documented. Amongst other positive effects it reduces the risk of infectious disease in infants. We evaluated the effect of breastfeeding in the length of stay for infants with moderately ill bronchiolitis. Patients and methods Prospective descriptive study including all moderately ill bronchiolitis infants admitted to our hospital between 2011-2014. They were grouped in exclusively breastfed or not. Severe bronchiolitis and patients with serious risk factors were excluded. The primary outcome was length of stay (LOS). The following variables were recorded: age, sex, atopic dermatitis, parental smoking, atopy in parents, number of siblings, RSV, treatment received and clinical scale of bronchiolitis at admission. Results Among the 185 enrolled infants, 54.5% were exclusively breastfed. There were no statistically significant differences (p > 0.05) in: male gender (47% vs 44%), atopic dermatitis (31% vs 31%), smoking parents (37% vs 44%), parental atopy (31% vs 31%), number of siblings (0.66 vs. 0.68) day care attendance (16% vs. 10%) and percentage of positive RSV (61% vs 60%). The median LOS in the breastfeeding group was 3.14 days compared with 2.82 days in the other group (p = 0.004). There were statistically significant differences in median age (p = 0.000) and the severity at admission (p = 0.021). Conclusion In our series, breastfeeding does not protect from bronchiolitis. The breastfed group were admitted at a younger age which could explain their longer LOS. Interestingly, breastfed infants had a lower score of severity at admission suggesting a relative protective role of against severe bronchiolitis. Background and aims Cardiac dysfunction during bronchiolitis has been reported but few studies have assessed right ventricular function (RVF). The aim of this study was to assess RVF in infants with severe bronchiolitis with different respiratory support. Methods Prospective study of under 3-month-old infants admitted to the PICU for severe bronchiolitis. Patients were classified in 3 groups according to the respiratory support: CPAP, bilevel positive airway pressure (BLPAP) and mechanical ventilation (MV). If the respiratory support was changed, echocardiography was repeated. Morphology and systolic and diastolic function were evaluated by echocardiography including Tissue Doppler imaging (TDI). O-017 RIGHT VENTRICULAR FUNCTION IN INFANTS WITH SEVERE BRONCHIOLITIS AND DIFFERENT RESPIRATORY SUPPORTResults 30 echocardiographies were performed: 9 in infants with CPAP (4-8 cmH 2 O), 10 in BLPAP (13-16 cmH 2 O/6-8 cmH 2 O) and 10 in MV (PEEP 5-9 cmH 2 O and MAP 9-17 cmH 2 O). There was no difference in age or weight between the groups. The most relevant results are shown in Table 1. Conclusions As respiratory support increases, decreased systolic and diastolic RVF is observed by TDI in infants with severe bronchiolitis. -2014-307384.87 Background and aims No bronchodilator nebulised in saline has significantly proven to be more effective than...

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