[Prediction of Severe Course in Infants with RSV Bronchiolitis under 6 Months. Spain]

Area of Science:

• Pediatric Critical Care Medicine
• Neonatology
• Infectious Diseases

Background:

• Respiratory syncytial virus (RSV) is a common cause of acute bronchiolitis (AB) in infants.
• Mechanical ventilation (MV) is sometimes required for severe cases of AB.
• Predicting the need for MV in infants with AB is crucial for resource allocation and timely intervention.

Purpose of the Study:

• To determine the incidence of pediatric intensive care unit (PICU) admission for MV in infants under 6 months with AB.
• To identify risk factors associated with the need for MV in this population.
• To develop a predictive model for severe AB requiring MV.

Main Methods:

• Retrospective study of infants under 6 months admitted with RSV-associated AB from 2010-2015.
• Analysis of clinical variables to identify risk factors for PICU admission and MV.
• Development of a binary logistic regression model and ROC curve analysis to assess predictive performance.

Main Results:

• 56 out of 695 infants (8.1%) required MV in the PICU.
• Significant risk factors for MV included male sex, low weight percentile, poor oral intake, clinical severity score, pre-admission apneas, and bacterial superinfection.
• Postmenstrual age and gestational age >37 weeks were protective factors.

Conclusions:

• The incidence of MV for AB in infants under 6 months is 8.1%.
• A predictive model incorporating identified risk factors can help identify infants at high risk for severe AB requiring MV.
• This model can aid clinicians in anticipating and managing severe cases.