Admission, discharge and triage guidelines for paediatric intensive care units in Spain

Oliva, P. De La; Cambra-Lasaosa, Francisco José; Quintana-Díaz, Manuel; Galán, Corsino Rey; Sánchez-Díaz, Juan Ignacio; Martín-Delgado, María Cruz; Carlos-Vicente, Juan Carlos de; Hernández-Rastrollo, Ramón; Holanda-Peña, María Soledad; Pilar-Orive, Francisco Javier; Ocete-Hita, Esther; Rodrı́guez-Núñez, Antonio; Serrano-González, Ana; Blanch, Luis Enrique Bruno

doi:10.1016/j.anpede.2017.10.002

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…PICU admission was deemed necessary if the patient presented with high supplemental oxygen requirement (FiO 2 (Inspiratory Fraction of Oxygen) ≥0.5 to maintain SpO 2 (Peripheral Saturation of Oxygen) ≥92%), need for non-invasive or invasive ventilation, rapidly progressive upper or lower airway disease, apnea observed by a physician or nurse or described as cyanosis and/or loss of consciousness and/or decreased muscle tone [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Prognostic Value of the Area of Lung Involved in Severe and Non-Severe Bronchiolitis: An Observational, Ultrasound-Based Study

Camporesi,

Vetrugno,

Morello

et al. 2023

JCM

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Background: Point of care lung ultrasound (LUS) has a definite role in viral bronchiolitis when combined with clinical data. Previous data showed a bigger involvement of the superior lung zones in more severe cases. The aim of the present study is to describe whether different lung areas are implicated to different degrees in patients admitted to a Pediatric Intensive Care Unit (PICU) and needing ventilation compared to those with less severe forms. Methods: observational, prospective study. LUS scores of single lung areas and clinical data were collected for all children aged 0–12 months presenting with bronchiolitis to the participating centers and used as covariates for logistic regression having “PICU admission” as outcome. A subsequent analysis was carried out to investigate factors concurring with different lung zones’ involvement. Results: 173 patients were enrolled. Difficulty in feeding, presence of wheezing, SpO2 were all risk factors for PICU admission. Superior lung areas’ LUS scores presented higher Odds Ratios for PICU admission and need for ventilation than inferior ones. Age and prematurity concurred in determining their higher LUS scores. Conclusions: Superior lobes’ greater involvement could be favored by the geometrical distribution of relative bronchi, exiting with an acute angle from mainstem bronchi in small children where airway caliber is small and only small volumes of secretions can be occlusive.

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Section: Methodsmentioning

confidence: 99%

Prognostic Value of the Area of Lung Involved in Severe and Non-Severe Bronchiolitis: An Observational, Ultrasound-Based Study

Camporesi,

Vetrugno,

Morello

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…PICU admission was deemed necessary if the patient presented with high supplemental oxygen requirement (FiO2 ≥ 0.5 to maintain SaO2 ≥ 92%), need for non invasive or invasive ventilation, rapidly progressive upper or lower airway disease, apnea observed by a physician or nurse or described as cyanosis and/or loss of consciousness and/or decreased muscle tone [22].…”

Section: Lung Ultrasoundmentioning

confidence: 99%

A combined rapid clinical and lung ultrasound score for predicting bronchiolitis severity

Camporesi

Morello

Guzzardella

et al. 2023

Preprint

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Introduction Lung Ultrasound (LUS) has demonstrated good correlation with clinical severity scores in bronchiolitis but should be combined with clinical data to achieve best results. Aim of the study is to create a quick and reliable clinical-ultrasound score to predict the risk of Pediatric Intensive Care (Picu) admission as soon as the patient enters the Emergency Department (ED). Methods Retrospective study conducted at two pediatric EDs. Lung was divided into six zones and scanned with ultrasound; every zone received a score. Clinical data were obtained. For the outcomes “Picu admission”and “Cpap ventilation”, a multivariate analysis was conducted and the significant factors resulting were used to create a 3- items score to predict Picu admission. Area under the Receiver-Operating Curve (AUC) for specificity and sensibility of the score was obtained. Results 74 patients were enrolled; 34% were admitted to PICU. 31% were treated with CPAP. For the outcome “PICU admission”, multivariate analysis demonstrated presence of wheezing and reduced oral intake to be significant together with ultrasound involvement of the Right Posterior Upper Zone and Left Posterior Basal Zone. For the outcome “CPAP ventilation”, same clinical factors plus involvement of Right Posterior Upper Zone were significant. A 3-items score (1: presence of wheezing; 2: reduced oral intake; 3: LUS involvement of Right Posterior Upper Zone) for prediction of PICU admission was created which presents an AUC of 0.8249. Conclusions We were able to create a simple and quick score to predict need for PICU admission in bronchiolitis.

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A combined rapid clinical and lung ultrasound score for predicting bronchiolitis severity

Camporesi,

Morello,

Guzzardella

et al. 2023

Intensive Care Med. Paediatr. Neonatal

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Introduction Lung ultrasound (LUS) has demonstrated a good correlation with clinical severity scores in bronchiolitis but should be combined with clinical data to achieve the best results. The aim of the study is to create a quick and reliable clinical-ultrasound score to predict the risk of paediatric intensive care (Picu) admission as soon as the patient enters the emergency department (ED). Methods A retrospective study conducted at two paediatric EDs. The lung was divided into six zones and scanned with ultrasound; every zone received a score. Clinical data were obtained. For the outcomes “PICU admission” and “CPAP support”, a multivariate analysis was conducted and the significant factors resulting were used to create a 3-item score to predict PICU admission. Area under the receiver-operating curve (AUC) for specificity and sensibility of the score was obtained. Results Seventy-four patients were enrolled; 34% were admitted to PICU. Thirty-one percent were treated with CPAP. For the outcome “PICU admission”, multivariate analysis demonstrated the presence of wheezing and reduced oral intake to be significant together with ultrasound involvement of the right posterior upper zone and left posterior basal zone. For the outcome “CPAP support”, same clinical factors plus involvement of the right posterior upper zone were significant. A 3-item score (1: presence of wheezing; 2: reduced oral intake; 3: LUS involvement of right posterior upper zone) for prediction of PICU admission was created which presents an AUC of 0.8249. Conclusions We were able to create a simple and quick score to predict the need for PICU admission in bronchiolitis.

show abstract

Admission, discharge and triage guidelines for paediatric intensive care units in Spain

Cited by 4 publications

References 28 publications

Prognostic Value of the Area of Lung Involved in Severe and Non-Severe Bronchiolitis: An Observational, Ultrasound-Based Study

Prognostic Value of the Area of Lung Involved in Severe and Non-Severe Bronchiolitis: An Observational, Ultrasound-Based Study

A combined rapid clinical and lung ultrasound score for predicting bronchiolitis severity

A combined rapid clinical and lung ultrasound score for predicting bronchiolitis severity

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