Prospective Multicenter Study of Children With Bronchiolitis Requiring Mechanical Ventilation

Mansbach, Jonathan M.; Piedra, Pedro A.; Stevenson, Michelle D.; Sullivan, Ashley F.; Forgey, Tate F.; Clark, Sunday; Espinola, Janice A.; Camargo, Carlos A.

doi:10.1542/peds.2012-0444

Cited by 153 publications

(128 citation statements)

References 66 publications

Supporting

Mentioning

119

Contrasting

Unclassified

Order By: Relevance

“…16,28 Our decision to use <90% as a threshold is based on the latest American Academy of Pediatrics recommendation 1 and on recent evidence revealing comparable outcomes in patients discharged with a saturation threshold of 90% vs 94%. 58 Interestingly, duration of symptoms was not associated with escalated care in this study.…”

Section: Figurementioning

confidence: 99%

Predicting Escalated Care in Infants With Bronchiolitis

Freire¹,

Kuppermann

Zemek

et al. 2018

Pediatrics

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES:Early risk stratification of infants with bronchiolitis receiving airway support is critical for focusing appropriate therapies, yet the tools to risk categorize this subpopulation do not exist. Our objective was to identify predictors of "escalated care" in bronchiolitis. We hypothesized there would be a significant association between escalated care and predictors in the emergency department. We subsequently developed a risk score for escalated care. METHODS:We conducted a retrospective cohort study of previously healthy infants aged <12 months with bronchiolitis. Our primary outcome was escalated care (ie, hospitalization with high-flow nasal cannula, noninvasive or invasive ventilation, or intensive care admission). The predictors evaluated were age, prematurity, day of illness, poor feeding, dehydration, apnea, nasal flaring and/or grunting, respiratory rate, oxygen saturation, and retractions. . One of 217 (0.5%) infants without predictors received escalated care. The risk score ranged from 0 to 14 points, with the estimated risk of escalated care from 0.46% (0 points) to 96.9% (14 points). The area under the curve was 85%. CONCLUSIONS:We identified variables measured in the emergency department predictive of escalated care in bronchiolitis and derived a risk score to stratify risk of this outcome. This score may be used to aid management and disposition decisions.

show abstract

Section: Figurementioning

confidence: 99%

Predicting Escalated Care in Infants With Bronchiolitis

Freire¹,

Kuppermann

Zemek

et al. 2018

Pediatrics

View full text Add to dashboard Cite

show abstract

“…These variables were chosen based on clinical plausibility and a priori knowledge. 4,5,27 We did not control for breastfeeding status because it was considered an ancestor variable of the association of interest (ie, the relationship between breastfeeding and likelihood of bronchiolitis may be mediated by gut microbiota), and adjustment of an ancestor variable would bias the inference toward the null.…”

Section: Statistical Analysesmentioning

confidence: 99%

The Fecal Microbiota Profile and Bronchiolitis in Infants

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…Two large prognostic studies have also identified retractions as predictors of severe disease in ED and hospitalized patients. 31,32 Decisions regarding hospitalization and length of stay in the ED are multifactorial. Nonrespiratory severity parameters (eg, feeding), prognostic factors (eg, age), social issues, clinical judgment, available resources, and local practices influence decisionmaking.…”

Section: 18mentioning

confidence: 99%