Increase in use of non-invasive ventilation for infants with severe bronchiolitis is associated with decline in intubation rates over a decade

Ganu, Subodh; Gautam, Anil; Wilkins, Barry; Egan, Jonathan R.

doi:10.1007/s00134-012-2566-4

Cited by 126 publications

(114 citation statements)

References 17 publications

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“…126 There is evidence that high-flow nasal cannula improves physiologic measures of respiratory effort and can generate continuous positive airway pressure in bronchiolitis. [127][128][129][130] Clinical evidence suggests it reduces work of breathing 131,132 and may decrease need for intubation, [133][134][135][136] although studies are generally retrospective and small. The therapy has been studied in the ED 136,137 and the general inpatient setting, 134,138 as well as the ICU.…”

Section: Action Statement Profile Kas 6bmentioning

confidence: 99%

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Ralston¹,

Lieberthal²,

Meissner³

et al. 2014

Pediatrics

1,421

1,654

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This guideline is a revision of the clinical practice guideline, “Diagnosis and Management of Bronchiolitis,” published by the American Academy of Pediatrics in 2006. The guideline applies to children from 1 through 23 months of age. Other exclusions are noted. Each key action statement indicates level of evidence, benefit-harm relationship, and level of recommendation. Key action statements are as follows:

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Section: Action Statement Profile Kas 6bmentioning

confidence: 99%

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Ralston¹,

Lieberthal²,

Meissner³

et al. 2014

Pediatrics

1,421

1,654

View full text Add to dashboard Cite

show abstract

“…If the study by Yanez and colleagues6 in which 60% of children were intubated when they received standard care is used as a benchmark, then consistent with that study, the observational studies suggest that use of NIV reduced intubation rates by about 50% (from 60% down to 10%–40%). Some studies, such as that by Ganu et al ,11 report an overall reduction in the proportion of children in intensive care unit (ICU) requiring intubation over a period of time when NIV use became more common.…”

Section: Uses Of Nivmentioning

confidence: 99%

The value of non-invasive ventilation

Hull¹

2014

Archives of Disease in Childhood

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Non-invasive ventilation (NIV) use has increased markedly over the last 10 years. Children being treated with NIV are now a common sight in most paediatric intensive care units and high dependency units and nearly all tertiary respiratory units will look after a cohort of children who use NIV at home. Although the published evidence base for use of NIV in acute and chronic respiratory failure is relatively weak, it is now very unlikely that there will be any more randomised controlled trials of this intervention. Effectiveness of NIV will need to be evaluated on each child as it used. It is important to define the purpose of using NIV in each child, and then determine whether it is effective.

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“…respiratory support is being performed at an earlier phase on less critically ill patients with bronchiolitis, 32 thereby leading to a reduction in observed mortality rates.…”

Section: Previous Studies Reported Increases In Bronchiolitis Hospitamentioning

confidence: 99%

Trends in Bronchiolitis Hospitalizations in the United States, 2000–2009

et al. 2013

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OBJECTIVE: To examine temporal trend in the national incidence of bronchiolitis hospitalizations, use of mechanical ventilation, and hospital charges between 2000 and 2009. METHODS: We performed a serial, cross-sectional analysis of a nationally representative sample of children hospitalized with bronchiolitis. The Kids Inpatient Database was used to identify children <2 years of age with bronchiolitis by International Classification of Diseases, Ninth Revision, Clinical Modification code 466.1. Primary outcome measures were incidence of bronchiolitis hospitalizations, mechanical ventilation (noninvasive or invasive) use, and hospital charges. Temporal trends were evaluated accounting for sampling weights. RESULTS: The 4 separated years (2000, 2003, 2006, and 2009) of national discharge data included 544 828 weighted discharges with bronchiolitis. Between 2000 and 2009, the incidence of bronchiolitis hospitalization decreased from 17.9 to 14.9 per 1000 person-years among all US children aged <2 years (17% decrease; Ptrend < .001). By contrast, there was an increase in children with high-risk medical conditions (5.9%–7.9%; 34% increase; Ptrend < .001) and use of mechanical ventilation (1.9%–2.3%; 21% increase; Ptrend = .008). Nationwide hospital charges increased from $1.34 billion to $1.73 billion (30% increase; Ptrend < .001); this increase was driven by a rise in the geometric mean of hospital charges per case from $6380 to $8530 (34% increase; Ptrend < .001). CONCLUSIONS: Between 2000 and 2009, we found a significant decline in bronchiolitis hospitalizations among US children. By contrast, use of mechanical ventilation and hospital charges for bronchiolitis significantly increased over this same period.

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Increase in use of non-invasive ventilation for infants with severe bronchiolitis is associated with decline in intubation rates over a decade

Cited by 126 publications

References 17 publications

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis

The value of non-invasive ventilation

Trends in Bronchiolitis Hospitalizations in the United States, 2000–2009

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