Clinico-virological Profile, Intensive Care Needs, and Outcome of Infants with Acute Viral Bronchiolitis: A Prospective Observational Study.
Acute bronchiolitis
Bronchiolitis
Intensive care
Mechanical ventilation
Respiratory syncytial virus
Journal
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
ISSN: 0972-5229
Titre abrégé: Indian J Crit Care Med
Pays: India
ID NLM: 101208863
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
entrez:
6
12
2021
pubmed:
7
12
2021
medline:
7
12
2021
Statut:
ppublish
Résumé
The objective of the study was to describe the clinico-virological profile, treatment details, intensive care needs, and outcome of infants with acute viral bronchiolitis (AVB). In this prospective observational study, 173 infants with AVB admitted to the pediatric emergency room and pediatric intensive care unit (PICU) of a tertiary care teaching hospital in North India during November 2019 to February 2020 were enrolled. The data collection included clinical features, viruses detected [respiratory syncytial virus (RSV), rhinovirus, influenza A virus, parainfluenza virus (PIV) 2 and 3, and human metapneumovirus (hMPV)], complications, intensive care needs, treatment, and outcomes. Multivariate analysis was performed to determine independent predictors for PICU admission. Most common symptoms were rapid breathing (98.8%), cough (98.3%), and fever (74%). On examination, tachypnea (98.8%), chest retractions (93.6%), respiratory failure (84.4%), wheezing (49.7%), and crepitations (23.1%) were observed. RSV and rhinovirus were the predominant isolates. Complications were noted in 25% of cases as encephalopathy (17.3%), transaminitis (14.3%), shock (13.9%), acute kidney injury (AKI) (7.5%), myocarditis (6.4%), multiple organ dysfunction syndrome (MODS) (5.8%), and acute respiratory distress syndrome (ARDS) (4.6%). More than one-third of cases required PICU admission. The treatment details included nasal cannula oxygen (11%), continuous positive airway pressure (51.4%), high-flow nasal cannula (14.5%), mechanical ventilation (23.1%), nebulization (74%), antibiotics (35.9%), and vasoactive drugs (13.9%). The mortality was 8.1%. Underlying comorbidity, chest retractions, respiratory failure at admission, presence of shock, and need for mechanical ventilation were independent predictors of PICU admission. Isolation of virus or coinfection was not associated with disease severity, intensive care needs, and outcomes. Among infants with AVB, RSV and rhinovirus were predominant. One-third infants with AVB needed PICU admission. The presence of comorbidity, chest retractions, respiratory failure, shock, and need for mechanical ventilation independently predicted PICU admission. Angurana SK, Takia L, Sarkar S, Jangra I, Bora I, Ratho RK,
Identifiants
pubmed: 34866830
doi: 10.5005/jp-journals-10071-24016
pmc: PMC8608649
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1301-1307Informations de copyright
Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.
Déclaration de conflit d'intérêts
Source of support: Authors thank the Regional Virus Research and Diagnostic Laboratory (RVRDL), Department of Health Research (DHR), Ministry of Health and Family Welfare (MoHFW), Government of India (GoI) for funding the study. Conflict of interest: None
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