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[Evolution of non-invasive ventilation in acute bronchiolitis]

B Toledo del Castillo1, S N Fernández Lafever1, C López Sanguos1

  • 1Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Instituto de Investigación del Hospital General Universitario Gregorio Marañón, Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, España.

Anales De Pediatria (Barcelona, Spain : 2003)
|December 24, 2014
PubMed

Insights

Non-invasive ventilation (NIV) use increased significantly in pediatric intensive care units for bronchiolitis, leading to reduced invasive ventilation (IV) and shorter hospital stays.

Area of Science:

  • Pediatric Intensive Care
  • Respiratory Medicine
  • Critical Care

Background:

  • Acute bronchiolitis is a common cause of pediatric intensive care unit (PICU) admission.
  • Ventilatory support, including non-invasive ventilation (NIV) and invasive ventilation (IV), is crucial for managing severe cases.

Purpose of the Study:

  • To analyze the 12-year trend in the utilization of NIV and IV for pediatric patients with acute bronchiolitis.
  • To compare ventilation strategies and outcomes between the first and second halves of the study period.

Main Methods:

  • Retrospective observational study of 196 children admitted to the PICU for acute bronchiolitis between 2001 and 2012.
  • Analysis of demographic data, ventilation methods (NIV vs. IV), and clinical outcomes.
  • Comparison of data from the first six years (2001-2006) versus the last six years (2007-2012).

Main Results:

  • NIV use increased from 79.4% to 100%, while IV use decreased from 46% to 22.6% over the study period.
  • Continuous positive airway pressure and nasopharyngeal tubes were common, with increased use of bi-level NIV and nasal cannulas in the latter period.
  • Median duration of IV was 9.5 days, NIV was 3 days, and PICU length of stay was 7 days, with a shorter stay in the second period.

Conclusions:

  • The increasing adoption of NIV for bronchiolitis in the PICU correlated with a decline in IV use.
  • This shift towards NIV was associated with a reduced length of PICU stay.
Abstract

Keywords:
BronchiolitisBronquiolitisChildrenContinuous positive airway pressureInvasive ventilationNiñosNon-invasive ventilationPresión positiva continua en la vía aéreaVentilación mecánicaVentilación mecánica no invasiva

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