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Burden of disease and change in practice in critically ill infants with bronchiolitis

Luregn J Schlapbach1,2,3,4, Lahn Straney5,4, Ben Gelbart6,7

  • 1Paediatric Critical Care Research Group, Mater Research Institute, The University of Queensland, Brisbane, Australia l.schlapbach@uq.edu.au.

The European Respiratory Journal
|June 3, 2017
PubMed

Insights

Pediatric intensive care unit (ICU) admissions for bronchiolitis have increased, with a significant shift from invasive ventilation to non-invasive support like high-flow nasal cannula therapy. This indicates changing management practices and an escalating healthcare burden.

Area of Science:

  • Pediatrics
  • Intensive Care Medicine
  • Respiratory Medicine

Background:

  • Bronchiolitis is a leading cause of non-elective pediatric intensive care unit (ICU) admissions.
  • Understanding trends in management and outcomes is crucial for resource allocation and care optimization.

Purpose of the Study:

  • To evaluate changes in the admission rate, respiratory support methods, and outcomes for infants with bronchiolitis admitted to ICUs.
  • To analyze trends in management practices and associated healthcare costs between 2002 and 2014.

Main Methods:

  • Retrospective analysis of non-elective ICU admissions for infants under 24 months with bronchiolitis.
  • Data collected from Australian and New Zealand ICUs between 2002 and 2014.
  • Assessment of admission rates, intubation rates, use of high-flow nasal cannula (HFNC) therapy, and hospitalisation costs.

Main Results:

  • Bronchiolitis accounted for 27.6% of non-elective ICU admissions, with an increasing population-based admission rate.
  • Intubation rates decreased significantly (36.8% to 10.8%), while HFNC use dramatically increased (to 72.6%).
  • Significant inter-unit variability in intubation rates was observed, and annual costs exceeded USD30 million by 2014.

Conclusions:

  • There is an increasing healthcare burden associated with severe bronchiolitis.
  • Management has shifted from invasive to non-invasive respiratory support, suggesting altered ICU admission thresholds.
  • Further research into bronchiolitis management strategies outside the ICU is warranted.

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