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与基线相比,2022年激增期间严重支气管炎的特征和结果
Rebecca E Audette1, Steven L Shein2
1Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, Ohio.
Hospital pediatrics
|January 22, 2026
概括
2022年儿科重症监护室 (PICU) 支气管炎急剧增加,患者入院人数增加了3倍,非侵入性呼吸支持增加,心脏骤停率与基线相比翻了一番. 这一激增使全国各地的医院受到压力,突出显示了疾病严重程度和护理实践的变化.
科学领域:
- 儿科重症监护 儿科重症监护
- 呼吸道感染 呼吸道感染
- 流行病学 流行病学
背景情况:
- 支气管炎患者进入儿科重症监护室 (PICU) 通常表现出季节性模式.
- 自2020年以来,支气管炎的入院模式已经明显偏离了历史规范.
- 2022年底的历史性增长给全国医院带来了前所未有的压力.
研究的目的:
- 为了比较患者的特征和临界支气管炎的结果,在2022年激增期间与基线时期相比.
- 分析呼吸支的变化,心脏骤停率,以及在激增期间获得的发病率.
主要方法:
- 利用虚拟儿科系统数据库对被诊断患有支气管炎的2岁以下患者进行了分析,并被录入PICU.
- 定义激增期为2022年10月至12月,不包括COVID-19大流行时期.
- 在63,838名患者中,使用奇平方测试和使用威尔科克森等级和值测试进行了对比的分类变量和连续变量.
主要成果:
- 每个中心每季度的PICU入院人数在激增期间 (60.0) 几乎是基线 (21.0) 的三倍.
- 激增期间,非侵入性连续正气道压力 (22.2%对15.3%) 和双级正气道压力 (21.0%对18.6%) 显著增加,输管率没有变化 (13.3%对12.6%).
- 与基线相比,心脏骤停率翻了一番 (0.9%与0.5%相比),获得的发病率在激增期间增加.
结论:
- 2022年的支气管炎急剧增长的标志是PICU患者数量异常高.
- 增加了非侵入性呼吸辅助的使用,更高的心脏骤停率,以及更高的获得性发病率,这些都是激增的特征.
- 潜在的促成因素包括改变宿主易感性,增加疾病严重程度,临床医生的行为转变以及非PICU呼吸支持实践的变化.
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