Severity of bronchiolitis in infants is associated with their parents' tobacco habit

Abstract

Objectives: Risk factors for severe acute bronchiolitis in previously healthy infants are scarcely known. This study investigated the effect of tobacco smoke exposure among severely Pediatric Intensive Care Unit (PICU) patients. Design: A prospective epidemiological observational study Setting: Tertiary pediatric medical center. Pediatric Intensive Care Unit (PICU) of Children's University Hospital La Paz Patient selection: Infants with bronchiolitis younger than 2 years of age during the October 2017 to March 2018 outbreak Methodology: On admission, parents were asked whether they smoked. In children who required invasive mechanical ventilation, endotracheal aspirate was collected at the time of intubation. Results: A total of 102 patients with bronchiolitis were studied. Among these, 14 (47%) of 30 infants whose parents smoked required invasive mechanical ventilation vs. 14 (19%) of 72 whose parents were nonsmokers (p=0.007) (RR 2.4; 95% CI 1.3-4.4). Among patients on invasive mechanical ventilation, 10 (71%) of 14 infants with secondhand smoke exposure presented PBI vs. 3 (21%) of 14 in the unexposed (p=0.012) (RR 3.3; 95% CI 1.2-9.6). PICU stay was 3 (IQR 3-6) days in infants whose parents didn t smoke, and 5 (IQR 3-11) days in infants whose parents smoked (p=0.01). Conclusions: Secondhand smoke exposure is an additional high risk for pulmonary bacterial superinfection, invasive mechanical ventilation and PICU length of stay in infants with severe acute bronchiolitis