[Evolution of non-invasive ventilation in acute bronchiolitis]

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.