Changes in Ventilation Practices for Bronchiolitis in the Hospital Ward and Need for ICU Transfer over the Last Decade

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Solana Gracia, Ruth and Modesto i Alapont, Vicent and Bueso Inchausti, Leticia and Luna Arana, María and Möller Díez, Ariadna and Medina Landaeta, Alberto Enrique and Pérez Moneo, Begoña (2022) Changes in Ventilation Practices for Bronchiolitis in the Hospital Ward and Need for ICU Transfer over the Last Decade. Journal of Clinical Medicine, 11 (6). p. 1622. ISSN 2077-0383

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Official URL: https://doi.org/10.3390/jcm11061622




Abstract

There is limited evidence of the potential benefits of the use of high-flow nasal cannula (HFNC) for the management of bronchiolitis in the ward. Our aim is to describe the ventilation trends for bronchiolitis in our hospital along with the introduction of an HFNC ward protocol and to determine the need for respiratory support escalation and transfer to an intensive care unit (ICU). A retrospective analytical observational study of children < 12 months old requiring admission for a first RSV bronchiolitis episode in a single centre from January 2009 to December 2018. The sample was divided into four groups according to the type of respiratory support that would ensure the clinical stability of the infants on admission. A total of 502 infants were recruited. The total number and percentage of patients admitted in the ward grew progressively over time. Simultaneously, there was an increase in HFNC and, paradoxically, an increase in ICU transfers. The risk of failure was higher for those who required HFNC or CPAP for clinical stabilisation in the first 12 h after admission. Moreover, the risk of failure was also higher in children with standard oxygen therapy promptly escalated to HFNC, especially if they had atelectasis/viral pneumonia, coinfections or a history of prematurity. Despite the limitations of a retrospective analysis, our study reflects usual clinical practice and no correlation was found between the usage of HFNC and a shorter length of hospital stay or less time spent on oxygen therapy.


Item Type:Article
Uncontrolled Keywords:continuous positive airway pressure; viral bronchiolitis; non-invasive ventilation; oxygen inhalation therapy; respiratory insufficiency
Subjects:Medical sciences > Medicine > Pneumology
ID Code:72870
Deposited On:14 Jun 2022 13:37
Last Modified:15 Jun 2022 07:15

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