Efficacy of interventions for bronchiolitis in critically ill infants: A systematic review and meta-analysis*

Davison, Caroline; Ventre, Kathleen M.; Luchetti, Marco; Randolph, Adrienne G.

doi:10.1097/01.pcc.0000128891.54799.67

Cited by 99 publications

(78 citation statements)

References 38 publications

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“…Currently, its treatment is supportive care. 7 Noninvasive ventilation can be used as primary ventilatory support, or CPAP, used either alone or with heliox. [8][9][10] In severe bronchiolitis the Wang clinical severity score ranges from 9 to 12.…”

Section: Introductionmentioning

confidence: 99%

Chest Physical Therapy in Acute Viral Bronchiolitis: An Updated Review

2013

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Section: Introductionmentioning

confidence: 99%

Chest Physical Therapy in Acute Viral Bronchiolitis: An Updated Review

2013

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“…Unfortunately, despite the high volume and significant economic impact of the disease, clinical trials have failed to establish any specific therapy as effective; therefore, supportive care is the mainstay of an evidencebased approach to the disease. [3][4][5][6][7] Nevertheless, overuse of ineffective therapy remains common in bronchiolitis, with overuse of b-agonists, corticosteroids, antibiotics, viral testing, and chest radiography all well documented. [8][9][10][11] In response to the problem, many hospitals have adopted quality improvement (QI) strategies, such as implementing clinical practice guidelines, intended to standardize the approach to bronchiolitis or to operationalize recommendations made in national evidence-based guidelines.…”

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confidence: 99%

Effectiveness of Quality Improvement in Hospitalization for Bronchiolitis: A Systematic Review

et al. 2014

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BACKGROUND: Bronchiolitis causes nearly 20% of all acute care hospitalizations for young children in the United States. Unnecessary testing and medication for infants with bronchiolitis contribute to cost without improving outcomes. OBJECTIVES:The goal of this study was to systematically review the quality improvement (QI) literature on inpatient bronchiolitis and to propose benchmarks for reducing unnecessary care. METHODS:Assisted by a medical librarian, we searched Medline, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library. Studies describing any active QI intervention versus usual care in hospitalized children ,2 years of age were included. Data were extracted and confirmed by multiple investigators and pooled by using a random effects model. Benchmarks were calculated by using achievable benchmarks of care methods. RESULTS:Fourteen studies involving .12 000 infants were reviewed. QI interventions resulted in 16 fewer patients exposed to repeated doses of bronchodilators per 100 hospitalized (7 studies) (risk difference: 0.16 [95% confidence interval: 0.11-0.21]) and resulted in 5.3 fewer doses of bronchodilator given per patient (95% confidence interval: 2

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“…No therapy has proven particularly useful, and evidence for overuse of unnecessary therapy is widely available. [1][2][3][4][5][6][7][8][9] In response, the American Academy of Pediatrics (AAP) published a clinical practice guideline with the intention to improve the care of bronchiolitis. 10,11 Furthermore, many institutions have published their own experience in reducing unnecessary care by using local guidelines and other quality improvement (QI) methods.…”

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confidence: 99%

A Multicenter Collaborative to Reduce Unnecessary Care in Inpatient Bronchiolitis

et al. 2016

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Dr Ralston conceptualized the project and codirected its implementation, coordinated and critically reviewed all analyses, and drafted the initial manuscript; Dr Garber conceptualized the project and codirected its implementation and critically reviewed and revised the manuscript; Ms Rice-Conboy coordinated all aspects of project design, implementation, and data collection and critically reviewed and revised the manuscript; Drs Mussman, Shadman, and Walley provided project leadership and content, performed a portion of the analysis, and critically reviewed and revised the manuscript; Ms Nichols performed the analyses, prepared all tables and fi gures, and critically reviewed the manuscript; and all authors approved the fi nal manuscript as submitted.

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Efficacy of interventions for bronchiolitis in critically ill infants: A systematic review and meta-analysis*

Abstract: Background-Viral bronchiolitis is the leading cause of respiratory failure among infants in the United States. Currently, the mainstay of treatment is supportive care. The effectiveness of treatments used for mechanically ventilated infants with bronchiolitis is unclear.

Cited by 99 publications

References 38 publications

Chest Physical Therapy in Acute Viral Bronchiolitis: An Updated Review

Chest Physical Therapy in Acute Viral Bronchiolitis: An Updated Review

Effectiveness of Quality Improvement in Hospitalization for Bronchiolitis: A Systematic Review

A Multicenter Collaborative to Reduce Unnecessary Care in Inpatient Bronchiolitis

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