Low age, low birthweight and congenital heart disease are risk factors for intensive care in infants with bronchiolitis

Mecklin, Minna; Heikkilä, Paula; Korppi, Matti

doi:10.1111/apa.14021

Cited by 27 publications

(31 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our study, infants aged < 1 year accounted for 97% of all admissions to our PICU with bronchiolitis. The majority of our cases were infants aged ≤ 2 months ( n = 150), and 70% of these were RSV positive, suggesting that younger infants are more vulnerable to severe RSV disease, which is consistent with the findings from previous studies [ 12 , 18 , 28 ].The association of younger age and prematurity with an increased risk of PICU admission was not unexpected and has been well described previously.…”

Section: Discussionsupporting

confidence: 92%

See 1 more Smart Citation

Characteristics of children admitted to intensive care with acute bronchiolitis

2018

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 92%

“…passive smoking, crowded household) and presence of co-morbidities (e.g. chronic pulmonary disease, congenital heart disease, immunodeficiency, neurologic disease) [ 4 , 18 , 28 , 31 ]. However, few studies have yet described factors associated with PICU admission and outcome.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of children admitted to intensive care with acute bronchiolitis

2018

View full text Add to dashboard Cite

show abstract

“…In two Finnish studies, the PICU treatment rate was 6% among infants hospitalised for bronchiolitis at ages less than 12 months or less than 6 months . Low birthweight, low gestational age and congenital heart disease are well‐known risk factors for intensive care and respiratory support in infants with bronchiolitis . In the present study, infants who did not respond sufficiently to HFNC treatment and needed another more effective method of respiratory support were more likely to be born preterm, with lower gestational age and birthweight.…”

Section: Discussionmentioning

confidence: 52%

Using high‐flow nasal cannulas for infants with bronchiolitis admitted to paediatric wards is safe and feasible

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…We also noted that the percentage of RSV infection gradually decreased with age, which suggests that younger infants are more vulnerable to RSV disease; this is consistent with the findings of previous studies. 18,19 A retrospective cohort study indicated that the reduced exposure of pregnant women to RSV epidemic contributed to more severe RSV-induced bronchiolitis in children under 6 months of age. 20 Therefore, RSV-induced bronchiolitis is common in 6 months age; this may be associated with the circulation of antibodies that are not associated with RSV infection during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Etiology and Clinical characteristics of bronchiolitis in Suzhou

Tan

Jiang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Bronchiolitis is a clinical syndrome commonly encountered in practice, particularly among infants and young children. To investigate the prevalence of pathogens in hospitalized infants with bronchiolitis and study the relationship between the clinical characteristics and pathogens. Methods We investigated the respiratory specimens and clinical data of 1012 children with bronchiolitis who were treated at the Children’s Hospital of Soochow University between November 2011 and December 2018. The nasopharyngeal aspirates were examined by direct immunofluorescence assay or polymerase chain reaction (PCR) to detect viruses and by PCR and enzyme-linked immunosorbent assay to detect Mycoplasma pneumoniae (MP). Results Of the 1012 children with bronchiolitis, 842 (83.2%) were detected at least a pathogen. 614 (60.7%) had single viral infections, 91 (9.0%) had MP infections, 70 (6.9%) had multiple viral infections, and 67 (6.6%) had mixed viral and MP infection. The most common pathogens detected were respiratory syncytial virus (RSV) (44.4%), MP (15.6%), and human rhinovirus (HRV) (14.4%). RSV was the most common pathogen detected in children less than 6 months. Coinfection was detected in 13.5% (137/1012) of the children, but it was less common in children less than 6 months. The age of children with single virus infection was the youngest. Children with single virus infection had a higher proportion of oxygen therapy compared with single MP infection. Conclusions The most common pathogen detected in children with bronchiolitis is RSV, followed by MP and HRV. Co-infections lead to prolonged illness and worsening of the symptoms Keywords: Etiology, Bronchiolitis, Infant, Respiratory syncytial virus, Mycoplasma pneumoniae

show abstract

Low age, low birthweight and congenital heart disease are risk factors for intensive care in infants with bronchiolitis

Abstract: Less than 0.1% of infants under the age of 12 months were admitted to the PICU for bronchiolitis. Low age, low birthweight or prematurity and CHD were independently significant risk factors for both intensive care and respiratory support.

Cited by 27 publications

References 29 publications

Characteristics of children admitted to intensive care with acute bronchiolitis

Characteristics of children admitted to intensive care with acute bronchiolitis

Using high‐flow nasal cannulas for infants with bronchiolitis admitted to paediatric wards is safe and feasible

Etiology and Clinical characteristics of bronchiolitis in Suzhou

Contact Info

Product

Resources

About