ObjectivesThe present study focused on respiratory syncytial virus bronchiolitis with
respiratory failure. The aim of the study was to determine whether noninvasive
ventilation reduces the need for endotracheal intubation or slows the clinical
progression of acute respiratory syncytial virus bronchiolitis by reducing the
incidence of infectious complications. MethodsThe present study was a retrospective cohort study. Cohort A was comprised of
children who were admitted to the pediatric intensive and special care unit from
2003-2005 before starting noninvasive ventilation; cohort B was comprised of
children who were admitted to the pediatric intensive and special care unit from
2006-2008 after starting noninvasive ventilation. With the exception of
noninvasive ventilation, the therapeutic support was the same for the two groups.
All children who were diagnosed with respiratory syncytial virus bronchiolitis and
respiratory failure between November 2003 and March 2008 were included in the
cohort. Demographic, clinical and blood gas variables were analyzed. ResultsA total of 162 children were included; 75% of the subjects were less than 3 months
old. Group A included 64 children, and group B included 98 children. In group B,
34 of the children required noninvasive ventilation. The distributions of the
variables age, preterm birth, congenital heart disease, cerebral palsy and chronic
lung disease were similar between the two groups. On admission, the data for blood
gas analysis and the number of apneas were not significantly different between the
groups. In group B, fewer children required invasive ventilation (group A: 12/64
versus group B: 7/98; p=0.02), and there was a reduction in
the number of cases of bacterial pneumonia (group A: 19/64 versus
group B: 12/98; p=0.008). There was no record of mortality in either of the
groups. ConclusionBy comparing children with the same disease both before and after noninvasive
ventilation was used for ventilation support, we verified a reduction in
infectious complications and cases requiring intubation.