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Occurrence and risk factors associated with seizures in infants with severe bronchiolitis

Annabelle Huguet1, Frederic Valla1, Joseph Toulouse2

  • 1Hospices Civils de Lyon, réanimation pédiatrique, Hôpital Femme Mère Enfant, F-69500, Bron, France.

European Journal of Pediatrics
|April 13, 2021
PubMed

Insights

Seizures affect over 3% of infants under three months with severe bronchiolitis. Key risk factors include hyponatremia and mechanical ventilation, highlighting neurological complications in these young patients.

Area of Science:

  • Pediatric Intensive Care
  • Neurology
  • Infectious Diseases

Background:

  • Severe bronchiolitis is a major cause of pediatric intensive care unit (PICU) admission and mechanical ventilation in infants.
  • Neurological complications, including seizures, are a growing concern in infants with severe bronchiolitis.
  • Understanding seizure occurrence and associated factors in this vulnerable population is crucial.

Purpose of the Study:

  • To determine the frequency of seizures in infants younger than three months admitted to the PICU for severe bronchiolitis.
  • To identify factors associated with seizure occurrence in this specific patient group.
  • To characterize seizures in very young infants with severe bronchiolitis.

Main Methods:

  • A single-center retrospective cohort study was conducted.
  • Data from 805 infants admitted to the PICU between 2010 and 2018 for severe bronchiolitis were analyzed.
  • Multivariable logistic regression was used to identify factors associated with seizures, with a p-value < 0.05 considered significant.

Main Results:

  • Twenty-six infants (3.2%) experienced seizures either before PICU admission or during their stay.
  • Hyponatremia (OR: 4.6) and invasive ventilation (OR: 2.6) were significantly associated with an increased likelihood of seizures.
  • The majority of patients (89.6%) required mechanical ventilation.

Conclusions:

  • Seizures are a notable complication in at least 3% of very young infants with severe bronchiolitis.
  • While seizure characteristics may differ from older infants, risk factors like hyponatremia and mechanical ventilation remain consistent.
  • These findings underscore the significant extrapulmonary neurological morbidity associated with severe bronchiolitis in infants.

Keywords:
HyponatremiaMechanical ventilationSeizureViral bronchiolitis

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