Related Experiment Video
Updated: Mar 8, 2026
Employing the Forced Oscillation Technique for the Assessment of Respiratory Mechanics in Adults
Published on: February 9, 2022
The modified respiratory index score (RIS) guides resource allocation in acute bronchiolitis
Shu-Ling Chong1, Oon Hoe Teoh2, Nivedita Nadkarni3
1Department of Emergency Medicine, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore.
Insights
A modified Respiratory Index Score (RIS) can predict hospital admission for infants with bronchiolitis. A score over 4 indicates a higher likelihood of needing respiratory support or IV hydration.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Pediatrics
Background:
- Bronchiolitis is a frequent childhood illness with rising healthcare demands.
- Accurate prediction of hospitalization is crucial for resource management.
Purpose of the Study:
- To evaluate the efficacy of a modified Respiratory Index Score (RIS) in predicting hospital admission for bronchiolitis.
- To assess the modified RIS's performance in identifying infants requiring significant medical intervention.
Main Methods:
- An observational prospective study was conducted in a pediatric emergency department.
- Included were children under 2 years with bronchiolitis, excluding those with specific risk factors.
- A warranted admission was defined by the need for airway intervention, IV hydration, or hospitalization of ≥2 days.
Main Results:
- A modified RIS score greater than 4 significantly predicted warranted admissions (aOR: 3.28).
- This predictive association remained robust even in children experiencing their first wheezing episode.
- The study analyzed 1,818 patients, with 1.0% requiring respiratory support and 5.6% needing IV hydration.
Conclusions:
- The modified RIS is a valuable, simple tool for predicting the need for respiratory support, IV hydration, and extended hospital stays in infants with bronchiolitis.
- This score aids in clinical decision-making for managing pediatric respiratory illnesses.
Background And Objective:
Bronchiolitis is a common disease in early childhood with increasing healthcare utilization. We aim to study how well a simple and improved respiratory score (the modified Respiratory Index Score [RIS]) would perform when predicting for a warranted admission.
Methods:
This is an observational prospective study, from June 2015 to December 2015 in a paediatric emergency department (ED) of a large tertiary hospital in Singapore. We included children aged less than 2 years old, presenting with typical symptoms and signs of bronchiolitis but excluded children with four or more previous wheezes, a gestation of <35 weeks, and known cardiopulmonary disease. We also performed a sensitivity analysis for children presenting with their first wheeze. We defined a warranted admission as a composite of: The need for airway intervention, intravenous hydration, and a hospital stay of 2 days or more.
Results:
Among 1,818 patients, the median age was 10.8 months (IQR 7.2-15.9). The median modified RIS score was 4.0 (IQR 3.0-5.0). A total of 19 (1.0%) children required respiratory support, 101 (5.6%) received intravenous hydration, and 571 (31.4%) required a hospital stay of 2 days or more. After adjusting for age and duration of illness, a modified RIS score of >4 predicted significantly for a warranted admission (adjusted Odds Ratio: 3.28, 95% confidence interval: 2.62-4.12). The association remained significant among children presenting with their first wheeze.
Conclusions:
This simple respiratory tool predicts for the need for respiratory support, intravenous hydration, and a significant hospital stay of 2 days or more. Pediatr Pulmonol. 2017; 52:954-961. © 2017 Wiley Periodicals, Inc.
More Related Videos
06:22Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
04:10Author Spotlight: Exploring Venous Waveforms for Non-Invasive Respiratory Monitoring in Pigs
Published on: March 8, 2024
Related Concept Videos
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:23Acute Respiratory Failure-IV
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:21Acute Respiratory Failure-I
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...