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Efficacy of interventions for bronchiolitis in critically ill infants: a systematic review and meta-analysis

Caroline Davison1, Kathleen M Ventre, Marco Luchetti

  • 1Department of Anaesthesia, St. George's Hospital, Tooting, London, UK.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|August 27, 2004
PubMed

Insights

No current treatments clearly improve outcomes for infants with severe bronchiolitis. Surfactant shows promise, while corticosteroids and ribavirin may offer benefits for respiratory support.

Area of Science:

  • Pediatrics
  • Critical Care Medicine
  • Respiratory Medicine

Background:

  • Viral bronchiolitis is a primary cause of respiratory failure in infants.
  • Current treatments primarily focus on supportive care.
  • Evidence for interventions in mechanically ventilated infants is limited.

Purpose of the Study:

  • To assess the evidence supporting treatments for critically ill infants with bronchiolitis.
  • To evaluate the effectiveness of available therapies.

Main Methods:

  • Systematic search of medical literature (PubMed, citations, expert contact).
  • Inclusion of randomized controlled trials (RCTs) involving infants in intensive care units.
  • Independent data extraction and quality assessment by two reviewers.

Main Results:

  • 16 RCTs were included from 2,319 screened citations.
  • Meta-analysis of surfactant studies indicated a trend toward reduced mechanical ventilation duration and significant reduction in ICU days.
  • Meta-analysis of systemic corticosteroid studies showed no significant effect on ventilation duration.

Conclusions:

  • No definitive effective interventions currently exist for critically ill infants with bronchiolitis.
  • Surfactant therapy appears promising for improving outcomes.
  • Corticosteroids and ribavirin may offer potential benefits.
Abstract

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