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Severe bronchiolitis in children.

A L Foo1, O M Chay, J Hiew

  • 1Department of Paediatrics Tan Tock Seng Hospital.

The Journal of the Singapore Paediatric Society
|January 1, 1991
PubMed
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Severe acute viral bronchiolitis affects infants, often requiring mechanical ventilation. Respiratory syncytial virus (RSV) is the primary cause, with most cases occurring in infants under one year old.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Respiratory Medicine

Background:

  • Acute viral bronchiolitis is a leading cause of pediatric respiratory illness, particularly in infants.
  • Severe cases pose a risk of acute respiratory failure, necessitating mechanical ventilation.
  • Infants with pre-existing cardiorespiratory conditions are at higher risk.

Purpose of the Study:

  • To analyze the clinical features, etiology, and outcomes of severe acute bronchiolitis.
  • To identify the common viral agents responsible for severe cases.
  • To evaluate treatment patterns and patient outcomes.

Main Methods:

  • Prospective study conducted over one year (November 1988 - October 1989).
  • Inclusion of 174 admitted cases of acute bronchiolitis.

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  • Analysis of clinical data, viral etiology, and patient outcomes for severe cases (52 patients).

    • Main Results:

    • 52 (29.9%) of 174 bronchiolitis cases were classified as severe.
    • Viral etiology was identified in 75% of severe cases, with Respiratory Syncytial Virus (RSV) being the most frequent.
    • 88.5% of severe cases involved infants under one year of age.
    • Despite viral cause, 88.2% received antibiotics.
    • One death occurred, and two patients required mechanical ventilation due to apnea.

    Conclusions:

    • Severe acute bronchiolitis predominantly affects infants under one year.
    • RSV is the main viral agent, but antibiotics are frequently, though often inappropriately, used.
    • Outcomes include a significant risk of apnea and mechanical ventilation, highlighting the severity of the condition.