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Outcomes of medically retrieved infants with bronchiolitis in high-income countries: A scoping review
Tina Kendrick1, Natasha Nassar2, Christine Stirling3
1NSW Newborn and Paediatric Emergency Transport Service, The Sydney Children's Hospitals Network, Australia; School of Nursing, University of Tasmania, Hobart TAS, Australia; Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia.
Insights
Up to 20% of infants with bronchiolitis need medical retrieval. Limited studies and reports exist on the outcomes of these critically ill infants, highlighting a need for better data to improve care and reduce healthcare costs.
Area of Science:
- Pediatrics
- Neonatal Care
- Respiratory Medicine
Background:
- Bronchiolitis is a leading cause of infant hospitalization.
- Outcomes for infants requiring interhospital transfer for bronchiolitis are not well understood.
Purpose of the Study:
- To summarize evidence on the rate, therapy, and outcomes of infants with bronchiolitis requiring medical retrieval.
- To identify gaps in current research and reporting.
Main Methods:
- Scoping literature review (1996-2022) using Joanna Briggs Institute methodology.
- Searched Medline, CINAHL, Cochrane Database, and grey literature from high-income countries.
- Included published studies and reports from retrieval services.
Main Results:
- 16 papers were selected from 12,677 records; 6 met inclusion criteria.
- Transfer rates ranged from 4.3% to 18.5%.
- Limited data reported on therapies and outcomes; no reports found from 103 medical retrieval services.
Conclusions:
- Up to one in five infants with bronchiolitis require medical retrieval.
- Significant gaps exist in understanding the outcomes of these infants.
- Further research is needed to optimize care, reduce avoidable transfers, and lessen healthcare burdens.
Introduction:
Bronchiolitis is the most common respiratory infection and reason for hospitalisation in infancy; however, outcomes of infants with bronchiolitis who require interhospital transfer by specialist medical retrieval services are poorly understood.
Objectives:
The objective of this study was to summarise current evidence of the rate, therapy, and outcomes of infants with bronchiolitis who required medical retrieval for ongoing management.
Review Method:
A scoping literature review informed by the Joanna Briggs Institute methodology was used including published studies in any language covering the period 1996 to December 2022 and grey literature sources comprised of reports from retrieval services in high-income countries with comparable healthcare systems.
Data Sources:
Medline, CINAHL, and the Cochrane Database of Systematic Reviews electronic databases were the sources for published studies. Grey literature sources were retrieval service web pages/social media sites from Australia, Canada, New Zealand, the United Kingdom, and the United States of America.
Results:
Searching identified 12 677 records, with 12 069 ineligible records and 286 duplicates excluded at screening. Of the 72 papers included for title and abstract review, 16 were selected for full-text review. Six papers fulfilled inclusion criteria. Infants with bronchiolitis were the primary focus of three studies. Transfer rate was reported in four studies, ranging from 4.3% to 18.5%. Use of respiratory therapy was variably reported and was associated with prematurity. Outcomes following retrieval such as respiratory therapies, days on therapies, length of stay in the intensive care unit, and hospital length of stay were only reported in two studies. Of 103 identified medical retrieval services and data registries, no reports were found that included information on the number of transfers or outcomes for infants with bronchiolitis.
Conclusions:
Up to one in five infants with bronchiolitis require medical retrieval. Only two published studies and no reports reported on the number and outcomes of infants. Given the frequency and severity of bronchiolitis, understanding indications for medical retrieval and outcomes of those infants may help to better target care and interventions for this common illness. Benefits could include diminishing the costly burden to families and the healthcare system of avoidable medical retrieval and interhospital transfer.
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