Intensive care unit admissions and ventilation support in infants with bronchiolitis

Ed Oakley, Vi Chong, Meredith Borland, Jocelyn M. Neutze, Natalie T. Phillips, David Krieser, Stuart R. Dalziel, Andrew Davidson, Susan Donath, Kim Jachno, Mike South, Amanda Fry, Franz E. Babl

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    8 Citations (Scopus)

    Abstract

    Objectives: To describe the rate of intensive care unit (ICU) admission, type of ventilation support provided and risk factors for ICU admission in infants with bronchiolitis. Design: Retrospective review of hospital records and Australia and New Zealand Paediatric Intensive Care (ANZPIC) registry data for infants 2–12 months old admitted with bronchiolitis. Setting: Seven Australian and New Zealand hospitals. These infants were prospectively identified through the comparative rehydration in bronchiolitis (CRIB) study between 2009 and 2011. Results: Of 3884 infants identified, 3589 charts were available for analysis. Of 204 (5.7%) infants with bronchiolitis admitted to ICU, 162 (79.4%) received ventilation support. Of those 133 (82.1%) received non-invasive ventilation (high flow nasal cannula [HFNC] or continuous positive airway pressure [CPAP]) 7 (4.3%) received invasive ventilation alone and 21 (13.6%) received a combination of ventilation modes. Infants with comorbidities such as chronic lung disease (OR 1.6 [95% CI 1.0–2.6]), congenital heart disease (OR 2.3 [1.5–3.5]), neurological disease (OR 2.2 [1.2–4.1]) or prematurity (OR 1.5 [1.0–2.1]), and infants 2–6 months of age (OR 1.5 [1.1–2.0]) were more likely to be admitted to ICU. Respiratory syncitial virus positivity did not increase the likelihood of being admitted to ICU (OR 1.1 [95% CI 0.8–1.4]). HFNC use changed from 13/53 (24.5% [95% CI 13.7–38.3]) patient episodes in 2009 to 39/91 (42.9% [95% CI 32.5–53.7]) patient episodes in 2011. Conclusion: Admission to ICU is an uncommon occurrence in infants admitted with bronchiolitis, but more common in infants with comorbidities and prematurity. The majority are managed with non-invasive ventilation, with increasing use of HFNC.

    Original languageEnglish
    Pages (from-to)421-428
    Number of pages8
    JournalEMA - Emergency Medicine Australasia
    Volume29
    Issue number4
    DOIs
    Publication statusPublished - 1 Aug 2017

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    Oakley, E., Chong, V., Borland, M., Neutze, J. M., Phillips, N. T., Krieser, D., Dalziel, S. R., Davidson, A., Donath, S., Jachno, K., South, M., Fry, A., & Babl, F. E. (2017). Intensive care unit admissions and ventilation support in infants with bronchiolitis. EMA - Emergency Medicine Australasia, 29(4), 421-428. https://doi.org/10.1111/1742-6723.12778