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[Clinical, therapeutic and developmental aspects of acute bronchiolitis in Tunisia]
N Ben Jaballah1, K Mnif, L Hedfi
1Unité de Réanimation Pédiatrique Polyvalente, Service de Médecine Infantile A, Hôpital d'Enfants Bab Saadoun, Tunis Jebbari, Tunisie.
Insights
Severe acute bronchiolitis in infants often requires intensive care, with respiratory syncytial virus (RSV) being a common cause. Many infants needed mechanical ventilation, and some experienced severe outcomes, including death.
Area of Science:
- Pediatrics
- Infectious Diseases
- Critical Care Medicine
Context:
- Severe acute bronchiolitis is a significant cause of pediatric hospital admissions.
- This study focuses on infants admitted to the Intensive Care Unit (ICU) in Tunis.
- Bronchiolitis accounts for a substantial proportion of severe bronchopulmonary infections in the ICU.
Purpose:
- To describe the clinical characteristics and outcomes of infants with severe acute bronchiolitis.
- To identify common etiological agents, particularly viruses like respiratory syncytial virus (RSV).
- To analyze the management and complications in critically ill infants.
Summary:
- Fourteen infants with severe acute bronchiolitis were admitted to the ICU, with ages ranging from 2 to 48 weeks.
- Respiratory syncytial virus (RSV) was identified in five patients. Thirteen patients required mechanical ventilation, with a mean duration of 9 days.
- Complications included respiratory arrest, atelectasis, inappropriate antidiuretic hormone secretion, and supraventricular tachycardia. One infant died, and another experienced severe respiratory sequelae.
Impact:
- Highlights the severity of acute bronchiolitis in infants and the critical role of intensive care.
- Emphasizes the significant burden of RSV infections in severe pediatric respiratory illness.
- Informs clinical management strategies and resource allocation for severe pediatric respiratory infections.
Abstract:
Fourteen infants with severe acute bronchiolitis were admitted to the Intensive Care Unit (ICU) of Tunis. This pathology represents 36% of severe bronchopulmonary infections admitted to this ICU. Their age ranged between 2 and 48 weeks (mean: 15 weeks). Eight infants had hypotrophy. Two infants had congenital heart disease and one infant had tracheo-bronchomalacia. Viruses were found in 6/11 patients. Respiratory syncytial virus (RSV) was identified in five patients and an adenovirus in one patient. Five patients had respiratory arrest at ICU admission. Ten infants had evidence of atelectasis on chest X-ray films. Thirteen patients required mechanical ventilation. One infant had inappropriate antidiuretic hormone secretion resulting in convulsions. One infant had supraventricular tachycardia. Both had RSV infection. One patient who had congenital heart disease and RSV infection died. In the other 12 patients receiving mechanical ventilation, the mean duration of ventilation was 9 days (range: 2-30 days). The second patient who had congenital heart disease and RSV infection had severe respiratory sequelae at discharge.