Has the introduction of high-flow nasal cannula modified the clinical characteristics and outcomes of infants with bronchiolitis admitted to pediatric intensive care units? A retrospective study.


Journal

Archives de pediatrie : organe officiel de la Societe francaise de pediatrie
ISSN: 1769-664X
Titre abrégé: Arch Pediatr
Pays: France
ID NLM: 9421356

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 22 01 2020
revised: 14 09 2020
accepted: 21 11 2020
pubmed: 19 12 2020
medline: 26 10 2021
entrez: 18 12 2020
Statut: ppublish

Résumé

This study aimed to assess how the emergence of high-flow nasal cannula (HFNC) has modified the demographic and clinical characteristics as well as outcomes of infants with bronchiolitis admitted to a pediatric intensive care unit (PICU). This was a single-center retrospective study including infants aged 1 day to 6 months with bronchiolitis requiring HFNC, noninvasive ventilation (NIV), or invasive ventilation on admission. A total of 252 infants (mean age 53±36 days) were included in the study. The use of HFNC increased from 18 (21.4%) during 2013-2014 to 53 infants (55.2%) during 2015-2016. The length of stay in the PICU decreased over time from 4.7±2.9 to 3.5±2.7 days (P<0.01) but the hospital length of stay remained similar (P=0.17). On admission, patients supported by HFNC as the first-line therapy were older. The PICU length of stay was similar according to the type of respiratory support (P=0.16), but the hospital length of stay was longer for patients supported by HFNC (P=0.01). The distribution of respiratory support has significantly changed over time for patients with bronchiolitis and HFNC is increasingly used. The demographic and clinical characteristics of the have not changed over time. However, the PICU length of stay decreased significantly.

Sections du résumé

BACKGROUND BACKGROUND
This study aimed to assess how the emergence of high-flow nasal cannula (HFNC) has modified the demographic and clinical characteristics as well as outcomes of infants with bronchiolitis admitted to a pediatric intensive care unit (PICU).
METHODS METHODS
This was a single-center retrospective study including infants aged 1 day to 6 months with bronchiolitis requiring HFNC, noninvasive ventilation (NIV), or invasive ventilation on admission.
RESULTS RESULTS
A total of 252 infants (mean age 53±36 days) were included in the study. The use of HFNC increased from 18 (21.4%) during 2013-2014 to 53 infants (55.2%) during 2015-2016. The length of stay in the PICU decreased over time from 4.7±2.9 to 3.5±2.7 days (P<0.01) but the hospital length of stay remained similar (P=0.17). On admission, patients supported by HFNC as the first-line therapy were older. The PICU length of stay was similar according to the type of respiratory support (P=0.16), but the hospital length of stay was longer for patients supported by HFNC (P=0.01).
CONCLUSION CONCLUSIONS
The distribution of respiratory support has significantly changed over time for patients with bronchiolitis and HFNC is increasingly used. The demographic and clinical characteristics of the have not changed over time. However, the PICU length of stay decreased significantly.

Identifiants

pubmed: 33334653
pii: S0929-693X(20)30256-6
doi: 10.1016/j.arcped.2020.11.006
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

141-146

Informations de copyright

Copyright © 2020 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.

Auteurs

E Delacroix (E)

Pediatric Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France.

A Millet (A)

Pediatric Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France.

I Wroblewski (I)

Pediatric Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France.

A Vilotitch (A)

Public Health Department, Grenoble Alpes University Hospital, Grenoble, France.

I Pin (I)

Pediatric Department, Grenoble Alpes University Hospital, Grenoble, France.

A Ego (A)

Public Health Department, Grenoble Alpes University Hospital, Grenoble, France.

T Debillon (T)

Neonatology Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France.

G Mortamet (G)

Pediatric Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France. Electronic address: gmortamet@chu-grenoble.fr.

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