Related Experiment Video
Updated: Mar 25, 2026
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Management of Bronchiolitis in Community Hospitals in Ontario: a Multicentre Cohort Study
Amy C Plint1, Monica Taljaard2, Candice McGahern3
1*Departments of Pediatrics and Emergency Medicine,University of Ottawa,Ottawa,ON.
Insights
Infants with bronchiolitis often receive unnecessary treatments like bronchodilators and corticosteroids in community hospitals. This study highlights the need for better evidence-based care strategies for pediatric bronchiolitis management.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Hospital Management
Background:
- Bronchiolitis is a common pediatric respiratory illness leading to infant hospitalizations.
- Management practices in community hospital settings remain under-examined.
- Understanding current treatment patterns is crucial for improving care.
Purpose of the Study:
- To review the management of infant bronchiolitis in community hospitals.
- To assess the utilization of medications and investigations for bronchiolitis.
- To identify areas for improvement in evidence-based practice.
Main Methods:
- Retrospective review of infant patients (<12 months) diagnosed with bronchiolitis.
- Data collected from 28 community hospitals in Ontario over two years.
- Bronchiolitis defined by wheezing and upper respiratory infection symptoms during RSV season.
Main Results:
- Nearly 30% of eligible infants were hospitalized, with wide variation in admission rates.
- Bronchodilators (e.g., Salbutamol) were frequently used in emergency departments and inpatient wards.
- Corticosteroids and chest X-rays were also commonly administered despite limited evidence of benefit.
Conclusions:
- Current management of infant bronchiolitis in community hospitals often involves treatments lacking proven efficacy.
- There is a clear need for knowledge translation initiatives to promote evidence-based guidelines.
- Optimizing bronchiolitis care in community settings can improve outcomes and resource utilization.
Objectives:
Bronchiolitis is the leading cause of hospital admission for infants, but few studies have examined management of this condition in community hospital settings. We reviewed the management of children with bronchiolitis presenting to community hospitals in Ontario.
Methods:
We retrospectively reviewed a consecutive cohort of infants less than 12 months old with bronchiolitis who presented to 28 Ontario community hospitals over a two-year period. Bronchiolitis was defined as first episode of wheezing associated with signs of an upper respiratory tract infection during respiratory syncytial virus season.
Results:
Of 543 eligible children, 161 (29.7%, 95% Confidence Interval (CI) 22.3 to 37.0%) were admitted to hospital. Hospital admission rates varied widely (Interquartile Range 0%-40.3%). Bronchodilator use was widespread in the emergency department (ED) (79.7% of patients, 95% CI 75.0 to 84.5%) and on the inpatient wards (94.4% of patients, 95% CI 90.2 to 98.6%). Salbutamol was the most commonly used bronchodilator. At ED discharge 44.7% (95% CI 37.5 to 51.9%) of patients were prescribed a bronchodilator medication. Approximately one-third of ED patients (30.8%, 95% CI 22.7 to 38.8%), 50.3% (95% CI 37.7 to 63.0%) of inpatients, and 23.5% (95% CI 14.4 to 32.7) of patients discharged from the ED were treated with corticosteroids. The most common investigation obtained was a chest x-ray (60.2% of all children; 95% CI 51.9 to 68.5%).
Conclusions:
Infants with bronchiolitis receive medications and investigations for which there is little evidence of benefit. This suggests a need for knowledge translation strategies directed to community hospitals.
