Predicting Escalated Care in Infants With Bronchiolitis

Freire, Gabrielle; Kuppermann, Nathan; Zemek, Roger; Plint, Amy C.; Babl, Franz E; Dalziel, Stuart R; Freedman, Stephen B.; Atenafu, Eshetu G.; Stephens, Derek; Steele, Dale W.; Fernandes, Ricardo M; Florin, Todd A.; Kharbanda, Anupam B.; Lyttle, Mark D; Johnson, David W.; Schnadower, David; Macias, Charles G.; Benito, Javier; Schuh, Suzanne

doi:10.1542/peds.2017-4253

Cited by 40 publications

(63 citation statements)

References 60 publications

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“…A retrospective cohort study published in 2018 identified predictors of escalated care in bronchiolitis and used these to derive a risk score to outline higher risk patients; validation of such a score would be beneficial. 11 …”

Section: Discussionmentioning

confidence: 99%

National survey of feasibility of NIV trials for management of children with bronchiolitis

Rosala-Hallas

Jones

Bedson

et al. 2020

bmjpo

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BackgroundBronchiolitis is a major cause of admission to hospital in children. Non-invasive ventilation (NIV) support with continuous positive airway pressure (CPAP) or high-flow nasal cannula (HFNC) oxygen is routinely used for infants in the UK with bronchiolitis.ObjectiveTo establish UK paediatric practice regarding management of bronchiolitis, and to explore issues pertinent to the design of a potential future randomised controlled trial of NIV.DesignScreening logs were completed in hospitals in England capturing information on paediatric bronchiolitis admissions. An online national survey of clinical practice was disseminated to healthcare professionals (HCPs) across the UK to ascertain current management strategies.ResultsScreening logs captured data on 393 infants from 8 hospitals. Reasons for admission were most commonly respiratory distress and/or poor fluid intake. Oxygen was administered for 54% of admissions. Respiratory (CPAP and HFNC) and non-respiratory support administered varied considerably. The national survey was completed by 111 HCPs from 76 hospitals. Data were obtained on criteria used to commence and wean NIV, responsibilities for altering NIV settings, minimum training requirements for staff managing a child on NIV, and numbers of trained staff. Most centres were interested in and capable of running a trial of NIV, even out of normal office hours.ConclusionsRespiratory and non-respiratory management of bronchiolitis in UK centres varies widely. A trial of HFNC oxygen therapy in this group of patients is feasible and HCPs would be willing to randomise patients into such a trial. Future work should focus on defining trial eligibility criteria.

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Section: Discussionmentioning

confidence: 99%

National survey of feasibility of NIV trials for management of children with bronchiolitis

Rosala-Hallas

Jones

Bedson

et al. 2020

bmjpo

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“…The Pediatric Emergency Research Networks (PERN) collaboration involves research organisations from USA, Canada, Europe, Spain, the UK and Ireland, Australia and New Zealand, and South and Central America, as well as contributions from additional countries outside a formal research network [37]. The collaboration has enabled a number of successful international multicentre projects to be completed [38][39][40][41][42][43].…”

Section: Context -Pediatric Emergency Research Network (Pern)mentioning

confidence: 99%

“…40 University of New Mexico, Albuquerque, NM, USA. 41 Department of Emergency Medicine, Stanford University, Stanford, CA, USA. 42 Global Pediatric Emergency Equity Lab at Stanford University, Stanford CA, USA.…”

Section: Acknowledgementsmentioning

confidence: 99%

Acute severe paediatric asthma: study protocol for the development of a core outcome set, a Pediatric Emergency Research Networks (PERN) study

Craig

Babl

Dalziel

et al. 2020

Trials

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Background: Acute severe childhood asthma is an infrequent, but potentially life-threatening emergency condition. There is a wide range of different approaches to this condition, with very little supporting evidence, leading to significant variation in practice. To improve knowledge in this area, there must first be consensus on how to conduct clinical trials, so that valid comparisons can be made between future studies. We have formed an international working group comprising paediatricians and emergency physicians from North America, Europe, Asia, the Middle East, Africa, South America, Central America, Australasia and the United Kingdom. Methods/design: A 5-stage approach will be used: (1) a comprehensive list of outcomes relevant to stakeholders will be compiled through systematic reviews and qualitative interviews with patients, families, and clinicians; (2) Delphi methodology will be applied to reduce the comprehensive list to a core outcome set; (3) we will review current clinical practice guidelines, existing clinical trials, and literature on bedside assessment of asthma severity. We will then identify practice differences in tne clinical assessment of asthma severity, and determine whether further prospective work is needed to achieve agreement on inclusion criteria for clinical trials in acute paediatric asthma in the emergency department (ED) setting; (4) a retrospective chart review in Australia and New Zealand will identify the incidence of serious clinical complications such as intubation, ICU admission, and death in children hospitalized with acute severe asthma. Understanding the incidence of such outcomes will allow us to understand how common (and therefore how feasible) particular outcomes are in asthma in the ED setting; and finally (5) a meeting of the Pediatric Emergency Research Networks (PERN) asthma working group will be held, with invitation of other clinicians interested in acute asthma research, and patients/families. The group will be asked to achieve consensus on a core set of outcomes and to make recommendations for the conduct of clinical trials in acute (Continued on next page)

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“…38 The collaboration has enabled a number of successful international multicentre projects to be completed. [39][40][41][42][43][44] Aims And Objectives…”

Section: Context -Pediatric Emergency Research Network (Pern)mentioning

confidence: 99%

Acute severe paediatric asthma: study protocol for the development of a core outcome set, a Pediatric Emergency Networks (PERN) study

Craig

Babl

Dalziel

et al. 2019

Preprint

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Background. Acute severe childhood asthma is an infrequent, but potentially life-threatening emergency presentation. There is a wide range of different approaches to this condition, with very little supporting evidence, leading to significant variation in practice. To improve knowledge in this area, there must first be consensus on how to conduct clinical trials, so that valid comparisons can be made between future studies. We have formed an international working group comprising paediatricians and emergency physicians from North America, Europe, Asia, the Middle East, Africa, South America, Central America, Australasia and the United Kingdom. Methods / design. A five-stage approach will be used: (1) A comprehensive list of outcomes relevant to stakeholders will be compiled through systematic reviews and qualitative interviews with patients, families, and clinicians; (2) A Delphi methodology will be applied to reduce the comprehensive list to a core outcome set; (3) We will review current clinical practice guidelines, existing clinical trials, and literature regarding bedside assessment of asthma severity. We will then identify practice differences in clinical assessment of asthma severity, and determine whether further prospective work is needed to achieve agreement on inclusion criteria for clinical trials on acute paediatric asthma in the emergency department setting; (4) A retrospective chart review in Australia and New Zealand will identify the incidence of serious clinical complications in children hospitalized with acute severe asthma, such as intubation, ICU admission, and death. Understanding the incidence of such outcomes will allow us to understand how common (and therefore how feasible) particular outcomes are in an asthma ED population; (5) Finally, a meeting of the PERN asthma working group will be held, with invitation of other clinicians interested in acute asthma research, and patients / families. The group will be asked to achieve consensus on a core set of outcomes and to make recommendations for the conduct of clinical trials on acute severe asthma. If this is not possible, the group will agree on a series of prioritized steps to achieve this aim. Discussion The development of an international consensus on core outcomes is an important first step towards the development of consensus guidelines and standardised protocols for RCTs in this population. This will enable us to better interpret and compare future studies, reduce risks of study heterogeneity and outcome reporting bias, and improve the evidence base for the management of this important condition.

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Predicting Escalated Care in Infants With Bronchiolitis

Cited by 40 publications

References 60 publications

National survey of feasibility of NIV trials for management of children with bronchiolitis

National survey of feasibility of NIV trials for management of children with bronchiolitis

Acute severe paediatric asthma: study protocol for the development of a core outcome set, a Pediatric Emergency Research Networks (PERN) study

Acute severe paediatric asthma: study protocol for the development of a core outcome set, a Pediatric Emergency Networks (PERN) study

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