Noninvasive ventilation for stabilization of patients with acute bronchiolitis during interhospital transport

To describe and compare the characteristics of patients with acute bronchiolitis (AB) transported between hospitals with noninvasive ventilation (NIV), initiated either by the paediatric transport team (PTT) or by the sending hospital (SH).

Retrospective, observational, single-centre study conducted by one PTT. We included all transports between 2 hospitals of patients with AB in which NIV was used between January 2021 and March 2024.

The sample included 263 transports with NIV, with initiation of NIV by the SH in 119 (45.2%) and by the PTT in 144 (54.8%). Initiation of NIV by the SH was associated with a shorter stabilization time, with a median of 40min (IQR: 33.3-47) compared to initiation by the PTT group, with a median of 47min (IQR: 40-56). The scores in the BROSJOD severity scale and the oxygen requirements were lower, both at the beginning and at the end of transport, in the group of patients in whom NIV was initiated at the SH. Incidents were documented in 14.1% (n=37) of transports, with a higher frequency of minor complications in the SH-initiated group, chiefly leaks and patient-ventilator asynchrony.

Patients with bronchiolitis who required transport with NIV benefited from early initiation of support in RH, as they were in better clinical condition during transport. Training SH staff in the use of NIV could decrease the incidence of the potential complications associated with this technique.