Trends in Bronchiolitis ICU Admissions and Ventilation Practices: 2010-2019

Overview

Journal Pediatrics

Specialty Pediatrics

Date 2021 May 11

PMID 33972381

Citations 25

Authors

Jonathan H Pelletier

Alicia K Au

Dana Fuhrman

Robert S B Clark

Christopher Horvat

Affiliations

Soon will be listed here.

Abstract

Objectives: To determine the changes in ICU admissions, ventilatory support, length of stay, and cost for patients with bronchiolitis in the United States.

Methods: Retrospective cross-sectional study of the Pediatric Health Information Systems database. All patients age <2 years admitted with bronchiolitis and discharged between January 1, 2010 and December 31, 2019, were included. Outcomes included proportions of annual ICU admissions, invasive mechanical ventilation (IMV), noninvasive ventilation (NIV), and cost.

Results: Of 203 859 admissions for bronchiolitis, 39 442 (19.3%) were admitted to an ICU, 6751 (3.3%) received IMV, and 9983 (4.9%) received NIV. ICU admissions for bronchiolitis doubled from 11.7% in 2010 to 24.5% in 2019 ( < .001 for trend), whereas ICU admissions for all children in Pediatric Health Information Systems <2 years of age increased from 16.0% to 21.1% during the same period ( < .001 for trend). Use of NIV increased sevenfold from 1.2% in 2010 to 9.5% in 2019 ( < .001 for trend). Use of IMV did not significantly change (3.3% in 2010 to 2.8% in 2019, = .414 for trend). In mixed-effects multivariable logistic regression, discharge year was a significant predictor of NIV (odds ratio: 1.24; 95% confidence interval [CI]: 1.23-1.24) and ICU admission (odds ratio: 1.09; 95% CI: 1.09-1.09) but not IMV (odds ratio: 1.00; 95% CI: 1.00-1.00).

Conclusions: The proportions of children with bronchiolitis admitted to an ICU and receiving NIV have substantially increased, whereas the proportion receiving IMV is unchanged over the past decade. Further study is needed to better understand the factors underlying these temporal patterns.

Citing Articles

"Comparative analysis of predictors of failure for high-flow nasal cannula in bronchiolitis".

Etrusco Zaroni Santos A, Caiado C, Daud Lopes A, de Franca G, Valerio C, Oliveira D PLoS One. 2024; 19(11):e0309523.

PMID: 39570893 PMC: 11581261. DOI: 10.1371/journal.pone.0309523.

Efficacies of different treatment strategies for infants hospitalized with acute bronchiolitis.

Jeong H, Park D, Ha E, Kim J, Shin J, Baek H Clin Exp Pediatr. 2024; 67(11):608-618.

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"Comparison between high-flow nasal cannula (HFNC) therapy and noninvasive ventilation (NIV) in children with acute respiratory failure by bronchiolitis: a randomized controlled trial".

Etrusco Zaroni Santos A, Caiado C, Daud Lopes A, de Franca G, Eisen A, Oliveira D BMC Pediatr. 2024; 24(1):595.

PMID: 39294604 PMC: 11412039. DOI: 10.1186/s12887-024-05058-6.

Integrated-omics analysis with explainable deep networks on pathobiology of infant bronchiolitis.

Ooka T, Usuyama N, Shibata R, Kyo M, Mansbach J, Zhu Z NPJ Syst Biol Appl. 2024; 10(1):93.

PMID: 39174575 PMC: 11341550. DOI: 10.1038/s41540-024-00420-x.

A randomized, embedded, pragmatic, Bayesian clinical trial examining clinical decision support for high flow nasal cannula management in children with bronchiolitis: design and statistical analysis plan.

Horvat C, Suresh S, James N, Aneja R, Au A, Berry S Trials. 2024; 25(1):484.

PMID: 39014495 PMC: 11253479. DOI: 10.1186/s13063-024-08327-y.

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