Infants under 6 months with bronchiolitis are most likely to need major medical interventions in the 5 days after onset

Pruikkonen, Hannele; Uhari, Matti; Dunder, Teija; Pokka, Tytti; Renko, Marjo

doi:10.1111/apa.12704

Cited by 19 publications

(23 citation statements)

References 29 publications

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“…Shefali-Patel et al [16] observed that healthcare utilization was significantly greater in the RSV compared to the non-respiratory group for respiratory outpatient visits (6.1 vs. 3.8), hospital admissions (2.3 vs. 0.3; P < 0.001), respiratory-related hospital admission (1.3 vs. 0; P < 0.001), duration of hospital admission (9.6 vs. 0.4 days; P < 0.001), pediatric ICU (PICU) admission (1.6 vs. 0 days; P < 0.001), respiratory primary care visits (12.4 vs. 9.4; P = 0.07), emergency department visits (3.0 vs. 0.7; P < 0.001), and respiratory emergency department visits (1.6 vs. 0.1; P < 0.001). Data from a Finnish study also showed that infants aged <6 months with bronchiolitis were most likely to need major medical interventions (supplementary oxygen, intravenous fluids, intravenous antibiotics or admission to the ICU) in the first 5 days after disease onset [76]. …”

Section: Resultsmentioning

confidence: 99%

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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Section: Resultsmentioning

confidence: 99%

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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“…Respiratory syncytial virus (RSV) is the most common causative agent in infant bronchiolitis and about 1–3% of each age cohort are treated in hospital for RSV or other viral respiratory infections . The need for intensive care has been reported to vary from 6% to 17% of infants hospitalized for bronchiolitis …”

Section: Introductionmentioning

confidence: 99%

High-flow oxygen therapy is more cost-effective for bronchiolitis than standard treatment-A decision-tree analysis

2016

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We evaluated the cost-effectiveness of high-flow nasal cannula (HFNC) to provide additional oxygen for infants with bronchiolitis, compared to standard low-flow therapy. The cost-effectiveness was evaluated by decision analyses, using decision tree modeling, and was based on real costs from our recently published retrospective case-control study. The data on the effectiveness of HFNC treatment were collected from earlier published retrospective studies, using admission rates to pediatric intensive care units (PICU). The analyses in the study showed that the expected treatment costs of each episode of infant bronchiolitis varied between €1,312-2,644 ($1,786-3,600) in the HFNC group and €1,598-3,764 ($2,175-5,125) in the standard treatment group. The PICU admission rates and consequential costs were lower for HFNC than for standard treatment. HFNC treatment proved more cost-effective than standard treatment in all the baseline analyses and was also more cost-effective in the sensitivity analyses, except for in the worst-case scenario analysis. In conclusion, our modeling demonstrated that HFNC was strongly cost-effective for infant bronchiolitis, compared to standard treatment because it was both more effective and less expensive. Thus, if children hospitalized for bronchiolitis need oxygen, it should be delivered as HFNC treatment. Pediatr Pulmonol. 2016;51:1393-1402. © 2016 Wiley Periodicals, Inc.

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“…In two Finnish studies, the PICU treatment rate was 6% among infants hospitalised for bronchiolitis at ages less than 12 months or less than 6 months . Low birthweight, low gestational age and congenital heart disease are well‐known risk factors for intensive care and respiratory support in infants with bronchiolitis .…”

Section: Discussionmentioning

confidence: 99%

“…Bronchiolitis is the main infectious reason for hospitalisation of less than 12‐month‐old infants when they do not have any notable underlying disease. On average, 1–3% of infants need to be treated in hospital and Finnish studies have reported that 6% of hospitalised infants were treated in a paediatric intensive care unit (PICU) . Bronchiolitis is diagnosed on a clinical basis, and existing guidelines recommend that the cornerstones of bronchiolitis treatment are careful monitoring of oxygenation and fluid intake and supplementing these and providing ventilator support as necessary .…”

Section: Introductionmentioning

confidence: 99%

Using high‐flow nasal cannulas for infants with bronchiolitis admitted to paediatric wards is safe and feasible

et al. 2018

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Infants under 6 months with bronchiolitis are most likely to need major medical interventions in the 5 days after onset

Abstract: Infants under 6 months of age with bronchiolitis were most likely to need MMIs in the first 5 days after disease onset.

Cited by 19 publications

References 29 publications

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

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

High-flow oxygen therapy is more cost-effective for bronchiolitis than standard treatment-A decision-tree analysis

Using high‐flow nasal cannulas for infants with bronchiolitis admitted to paediatric wards is safe and feasible

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