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[Severe bronchiolitis. Epidemiology and clinical course of 284 patients]

A López Guinea1, J Casado Flores, María A Martín Sobrino

  • 1Servicio de Cuidados Intensivos Pediátricos, Hospital Infantil Universitario Niño Jesús, Madrid, España. slguin@hotmail.com

Anales De Pediatria (Barcelona, Spain : 2003)
|August 19, 2007
PubMed

Insights

Severe bronchiolitis in infants often requires pediatric intensive care unit (PICU) admission, with young age being a key risk factor. Apnea and pulmonary consolidation predict a severe clinical course, though overall mortality remains low.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Respiratory medicine

Background:

  • Bronchiolitis is a leading cause of infant hospitalization and pediatric intensive care unit (PICU) admission during winter.
  • Understanding the characteristics and clinical course of severe bronchiolitis cases is crucial for optimizing patient care.

Purpose of the Study:

  • To analyze the patient characteristics and clinical course of infants admitted to the PICU for severe bronchiolitis.
  • To identify predictors of severe disease, need for mechanical ventilation, and prolonged PICU stay.

Main Methods:

  • A descriptive, observational study was conducted.
  • Clinical charts of 284 patients admitted to the PICU for severe bronchiolitis between November 1994 and March 2006 were reviewed.

Main Results:

  • Respiratory syncytial virus (RSV) was identified in 74% of patients.
  • The most common risk factor for severe disease was young age (< 6 weeks, 45%), followed by prematurity (30%).
  • Mechanical ventilation was required in 24% of patients; predictors included multiple risk factors, apnea, and pulmonary consolidation on chest X-ray.

Conclusions:

  • Young age is the primary risk factor for severe bronchiolitis requiring PICU admission in otherwise healthy infants.
  • The presence of apnea and pulmonary consolidation are key predictors of a severe clinical course.
  • Bronchiolitis-associated mortality is low, primarily linked to pre-existing chronic illnesses.
Abstract

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