Initial non-invasive ventilation in infants under 1 year of age with severe bronchiolitis in the emergency department of a pediatric hospital: a retrospective study
Abstract
Objective: To describe the outcomes of noninvasive ventilation (NIV) at admission to the emergency department (ED) in infants under 1 year of age with severe bronchiolitis, and to explore differences between the success and failure groups.
Materials and methods: A descriptive, retrospective, and observational study with an exploratory between-group comparative analysis, based on ED records from a pediatric hospital between January 2018 and December 2021. Infants under 1 year of age with acute hypoxemic respiratory failure who required NIV in the ED prior to transfer to the pediatric intensive care unit (PICU) were included.
Results: A total of 83 subjects were included, with a median age of 1 month (IQR 1–4) and a median weight of 5 kg (IQR 3–7). Of these, 19 (23 %) had at least one chronic condition. The median Tal score was 10 (IQR 9–10). NIV was successful in 48 subjects (58 %), with a median inspiratory positive airway pressure of 17 cmH₂O (IQR 16–18), expiratory positive airway pressure of 7 cmH₂O (IQR 6–8), and a PICU length of stay of 4 days (IQR 5–6). Subjects who required orotracheal intubation had a longer PICU stay (median 11 days [IQR 8–14] vs. median 4 days [IQR 5–6]; p < 0.01). One death (1.2 %) was recorded.
Conclusion: NIV helped avoid orotracheal intubation in more than half of infants with severe bronchiolitis and was associated with a shorter PICU length of stay.
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