Respiratory Support during Bronchiolitis Due to One Virus versus More Than One Virus: An Observational Study

Coleman, Thomas R.; Taylor, Alison; Crothall, Helen; Martinez, F. Eduardo

doi:10.1055/s-0039-1691839

Cited by 4 publications

(4 citation statements)

References 31 publications

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“…Coleman et al observed a similar duration of respiratory support and PICU hospitalization in patients infected with a single virus compared with patients infected with more than one virus. 19 These data are consistent with the results published by Ghazaly and Nadel that did not find out clinical or radiologic differences between single and multiple VRIs in a cohort of 422 children. 13 Other studies show, however, conflicting data; in particular, recently, the multivariable regression analysis of a study on 477 infants admitted to the PICU with one or multiple organisms showed an association between coinfections and higher odds of longer PICU stay, prolonged mechanical ventilation, central line requirement, and bacterial coinfection.…”

Section: Discussionsupporting

confidence: 92%

“…Rates of viral coinfection reported in other studies range from 6% to more than 30%, but the correlation with greater disease severity and longer length of ICU staying is unclear to date. Coleman et al observed a similar duration of respiratory support and PICU hospitalization in patients infected with a single virus compared with patients infected with more than one virus 19 . These data are consistent with the results published by Ghazaly and Nadel that did not find out clinical or radiologic differences between single and multiple VRIs in a cohort of 422 children 13 .…”

Section: Discussionsupporting

confidence: 82%

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Severe viral respiratory infections in the pre‐COVID era: A 5‐year experience in two pediatric intensive care units in Italy

Luca

D’Amore

Romani

et al. 2022

Influenza Resp Viruses

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Background: Viral respiratory infections are one of the main causes of hospitalization in children. Even if mortality rate is low, 2% to 3% of the hospitalized children need mechanical ventilation. Risk factors for admission to the pediatric intensive care unit (PICU) are well known, while few studies have described risk factors for invasive ventilator support and prolonged hospitalization.Methods: A retrospective study including all patients aged between 2 and 18 months with a confirmed viral respiratory infection, requiring admission to PICU from September to March between 2015 and 2019, was conducted at Bambino Gesù Children's Hospital in Rome, Italy.Results: One hundred ninety patients were enrolled, with a median age of 2.7 months; 32.1% had at least one comorbidity, mainly prematurity. The most frequent isolated viruses were RSV-B, rhinovirus, and RSV-A; 38.4% needed mechanical ventilation. This subgroup of patients had lower median birth weight compared with patients not requiring mechanical ventilation (2800 g vs. 3180 g, p = 0.02);

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 82%

Severe viral respiratory infections in the pre‐COVID era: A 5‐year experience in two pediatric intensive care units in Italy

Luca

D’Amore

Romani

et al. 2022

Influenza Resp Viruses

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“…In most studies RSV-positive infants had a prolonged PICU length of stay, whereas we did not nd any correlation in our study [7,16,18]. Infants with viral coinfection did not have a longer PICU length of stay, which is consistent with most studies, but they did require more invasive ventilation [19,23,24]. As in other studies, we found that the presence of apneas was a risk factor for prolonged PICU length of stay, however, to our knowledge no publication showed that the presence of bradycardia further increased the PICU length of stay [7,8,21].…”

Section: Discussionsupporting

confidence: 86%

Predictors of prolonged length of stay in PICU of infants with severe bronchiolitis: are initial blood gases helpful?

Laruelle,

Rambaud,

Léger

et al. 2024

Preprint

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Purpose Every year between November and January, the epidemic of acute viral bronchiolitis causes massive admissions to pediatric intensive care units. One of the challenges is to identify infants who will require invasive ventilation or have a prolonged length of stay in intensive care units. Methods We conducted a multicenter retrospective study on three PICU wards in France to evaluate the different risk factors for prolonged hospitalization in pediatric intensive care and for invasive ventilation. We focused particularly on the blood gas parameters (pH, PCO2, and bicarbonate) before and after PICU admission. Results We included 268 patients between October 2018 and April 2019. Mean age was 62 days, 7% of infants had chronic conditions (bronchopulmonary dysplasia, congenital heart disease, etc.). The median length of stay in PICU was 4 days, 83% of infants required noninvasive ventilation and 6% required invasive ventilation. Variables associated with prolonged length of stay in PICU were an age less than 30 days, a severe comorbidity, onset of symptoms less than 3 days before admission, initial FiO2 above 30%, presence of apneas or bradycardia, hemodynamic failure, and presence of bacterial coinfection. The pH, PCO2 and bicarbonate after PICU admission were correlated with PICU length of stay whereas none of the blood gas parameters before admission. Conclusion Blood gas after PICU admission may be useful to predict the length of stay in PICU in patients whose clinical condition is difficult to evaluate.

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“…They also did not find an association between disease severity and co-infections, which was corroborated by a recently published meta-analysis [39]. A retrospective observational study on mechanically ventilated children with bronchiolitis admitted to the PICU showed no differences on duration of respiratory support or PICU length of stay between bronchiolitis caused by only one virus and more than one virus [40]. Hospital length of stay, however, was longer in the co-detection group.…”

Section: Discussionmentioning

confidence: 72%

IL-33 and ST2 as predictors of disease severity in children with viral acute lower respiratory infection

et al. 2020

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A B S T R A C TBackground: Mechanisms influencing severity of acute lower respiratory infection (ALRI) in children are not established. We aimed to assess the role of inflammatory markers and respiratory viruses in ALRI severity. Methods: Concentrations of interleukin(IL)-33, soluble suppression of tumorigenicity (sST)2, IL-1ß, tumor necrosis factor α, IL-4, IL-6 and IL-8 and types of respiratory viruses were evaluated in children at the first and fifth days after hospital admission. Disease severity was defined as need for mechanical ventilation. Results: Seventy-nine children < 5 years-old were included; 33(41.8%) received mechanical ventilation. No associations between virus type, viral load or co-detections and severity of disease were observed. Detection of IL-33 and sST2 in nasopharyngeal aspirates (NPA) on admission were associated with higher risk for mechanical ventilation (RR = 2.89 and RR = 4.57, respectively). IL-6 and IL-8 concentrations were higher on Day 5 in mechanically ventilated children. IL-6 NPA concentrations decreased from Day 1 to Day 5 in children who did not receive mechanical ventilation. Increase in sST2 NPA concentrations from Day 1 to Day 5 was associated with longer hospital length of stay (p < 0.01). Conclusions: An exacerbated local activation of the IL-33/ST2 axis and persistently high sST2 concentrations over time were associated with severity of viral ALRI in children.

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Respiratory Support during Bronchiolitis Due to One Virus versus More Than One Virus: An Observational Study

Cited by 4 publications

References 31 publications

Severe viral respiratory infections in the pre‐COVID era: A 5‐year experience in two pediatric intensive care units in Italy

Severe viral respiratory infections in the pre‐COVID era: A 5‐year experience in two pediatric intensive care units in Italy

Predictors of prolonged length of stay in PICU of infants with severe bronchiolitis: are initial blood gases helpful?

IL-33 and ST2 as predictors of disease severity in children with viral acute lower respiratory infection

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