Factors associated with disease severity in children with bronchiolitis

Sala, Kathleen; Moore, A. B.; Desai, Shreena; Welch, Katelyn; Bhandari, Shreya; Carroll, Christopher L.

doi:10.3109/02770903.2014.956893

Cited by 30 publications

(30 citation statements)

References 24 publications

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“…During acute bronchiolitis infections, younger children and those with a history of prematurity were more likely to suffer from severe disease. 12 In the present study, we did not observe such correlation, since there were only 8.6% were preterm babies and 99% of children admitted with bronchiolitis in our hospital were ≤12 months of age. We observed that breastfeeding did do not have too significant impact on the severity of disease since 50/105 (47.6%) did not receive breastfeed.…”

Section: Discussioncontrasting

confidence: 39%

Influence of seasonal variation on severity and outcomes in acute bronchiolitis

Saheb

Reddy

2017

Int J Contemp Pediatr

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Background: Bronchiolitis is a predominant cause of respiratory insufficiency and hospitalization in infants during the first year of their life. Respiratory syncytial virus (RSV) has been the major causative virus; other viruses also cause bronchiolitis. Some are activated in winter while another virus in non-winter seasons. This seasonal trend affects the morbidity in infants. In the Indian context, data regarding seasonal influence on the severity and complications of acute bronchiolitis is less. Hence, this study was undertaken to assess the influence of season on morbidity on mortality in acute bronchiolitis.Methods: Infants or children <2 years of age, with the first episode of acute bronchiolitis diagnosed clinically, were evaluated. Clinical, demographic, radiological and risk factors were recorded and correlated with seasons.Results: The age of the infants was 4.0±2.9 months. Peak occurrence (87.7%) was within six months of age. 78/105 (74.3%) of bronchiolitis occurred during July to December. 22/105 (20.9%) were mild, 43/105 (43.9%) were moderate, and 40/105 (38.9%) were severe. The order of chest X-ray findings are consolidation <atelectasis <normal <pulmonary infiltrates <bilateral Hyperareation. Apnea was seen in 2.9%, Otitis media in 7.6% and seizures in 3.8% of infants. The season did not show statistically significant trend on the severity of bronchiolitis. There were no infant deaths due to bronchiolitis in the present study.Conclusions: In the present study, the season did not show statistically significant trend on the severity of bronchiolitis. Studies with more extensive population are needed to reassess the seasonal effects on morbidity of acute bronchiolitis.

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Section: Discussioncontrasting

confidence: 39%

Influence of seasonal variation on severity and outcomes in acute bronchiolitis

Saheb

Reddy

2017

Int J Contemp Pediatr

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“…In contrast to other studies, while admission to the ICU was associated with a history of premature birth (odds ratio [OR]: 1.7; 95% CI: 1.1–2.4, P = 0.01), Sala et al [77] found no significant difference in the ICU LOS (106 [42–252] days vs. 106 [59–219] days; P = 0.94) or in mechanical ventilation (OR: 1.1; 95% CI: 0.6–2.1; P = 0.8) between infants with and without a history of prematurity. Similarly, Gijtenbeek et al [43] found no relation between gestational age and disease severity or in hospitalization LOS or use of mechanical ventilation and oxygen.…”

Section: Resultsmentioning

confidence: 82%

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Preterm Infants Without Chronic Lung Disease or Congenital Heart Disease

Manzoni

Paes

et al. 2016

Infect Dis Ther

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IntroductionThe REGAL (RSV Evidence—a Geographical Archive of the Literature) series provide a comprehensive review of the published evidence in the field of respiratory syncytial virus (RSV) in Western countries over the last 20 years. This second publication covers the risk and burden of RSV infection in preterm infants born at <37 weeks’ gestational age (wGA) without chronic lung disease or congenital heart disease.MethodsA systematic review was undertaken for articles published between January 1, 1995 and December 31, 2015. Studies reporting data for hospital visits/admissions for RSV infection among preterm infants as well as studies reporting RSV-associated morbidity, mortality, and risk factors were included. Study quality and strength of evidence (SOE) were graded using recognized criteria.Results2469 studies were identified of which 85 were included. Preterm infants, particularly those born at lower wGA, tended to have higher RSV hospitalization (RSVH) rates compared with otherwise healthy term infants (high SOE). RSVH rates ranged from ~5 per 1000 children to >100 per 1000 children with the highest rates shown in the lowest gestational age infants (high SOE). Independent risk factors associated with RSVH include: proximity of birth to the RSV season, living with school-age siblings, smoking of mother during pregnancy or infant exposure to environmental smoking, reduced breast feeding, male sex, and familial atopy (asthma) (high SOE). Predictive models can identify 32/33–35 wGA infants at risk of RSVH (high SOE).ConclusionRSV infection remains a major burden on Western healthcare systems and is associated with significant morbidity. Further studies focusing on the prevalence and burden of RSV in different gestational age cohorts, the changing risk of RSVH during the first year of life, and on RSV-related mortality in preterm infants are needed to determine the true burden of disease.FundingAbbVie.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-016-0130-1) contains supplementary material, which is available to authorized users.

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“…The number of patients assessed eligibility was decreased because we excluded infants aged younger than 2 months (13 infants), with low birth weight (7 infants), and those born before [26][27] . Therefore, including such infants is considered to be harmful for the homogeneity of study patients.…”

Section: Discussionmentioning

confidence: 99%

Rational drug use for acute bronchiolitis in emergency care

Uysalol¹,

Haşlak²,

Özünal³

et al. 2017

Turk J Pediatr

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Despite the large variety of inhaled treatment options of acute bronchiolitis, there is no generally agreed treatment regime. This study aimed to determine the most appropriate treatment option. This was a double-blind randomized prospective clinical trial and has been performed in emergency department. The mean age of the 378 infants included in the study was 7.63 ± 4.6 months, and 54.8% (207) were boys. Patients were randomized by using the lottery method for simple random sample into 5 different treatment options; 3% hypertonic saline, nebulized adrenaline, nebulized adrenaline mixed with 3% hypertonic saline, nebulized salbutamol, and as control group; normal saline (0.9% NaCl). From the first treatment time until discharge time; treatment durations, adverse events and readmission rates within the first fifteen days were recorded for each patient. Nebulized adrenaline mixed with 3% hypertonic saline, as compared with other options, were associated with a significantly higher discharge rate at 4 th hours (p<0.001) and shorter length of hospital stay (p=0.039). However, there was no significant difference between options with regard to adverse events, discharge rates at 24 th hours, and readmission rates within the first fifteen days. The superiority of discharge rates at 4 hours of nebulized adrenaline mixed with 3% hypertonic saline, was evaluated as 'better acute response' and can be helpful to reduce hospitalization needs. Additionally, this option seems to be more effective to reduce length of hospital stay.

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Factors associated with disease severity in children with bronchiolitis

Abstract: During acute bronchiolitis infections, younger children and those with a history of prematurity were more likely to be admitted to the ICU with severe disease.

Cited by 30 publications

References 24 publications

Influence of seasonal variation on severity and outcomes in acute bronchiolitis

Influence of seasonal variation on severity and outcomes in acute bronchiolitis

Defining the Risk and Associated Morbidity and Mortality of Severe Respiratory Syncytial Virus Infection Among Preterm Infants Without Chronic Lung Disease or Congenital Heart Disease

Rational drug use for acute bronchiolitis in emergency care

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