Trends in Bronchiolitis ICU Admissions and Ventilation Practices: 2010-2019.

Autor:	Pelletier JH; Division of Pediatric Critical Care Medicine, Department Critical Care Medicine, and., Au AK; Division of Pediatric Critical Care Medicine, Department Critical Care Medicine, and., Fuhrman D; Division of Pediatric Critical Care Medicine, Department Critical Care Medicine, and., Clark RSB; Division of Pediatric Critical Care Medicine, Department Critical Care Medicine, and., Horvat C; Division of Pediatric Critical Care Medicine, Department Critical Care Medicine, and christopher.horvat@chp.edu.; Division of Health Informatics, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Jazyk:	angličtina
Zdroj:	Pediatrics [Pediatrics] 2021 Jun; Vol. 147 (6). Date of Electronic Publication: 2021 May 10.
DOI:	10.1542/peds.2020-039115
Abstrakt:	Objectives: To determine the changes in ICU admissions, ventilatory support, length of stay, and cost for patients with bronchiolitis in the United States. Methods: Retrospective cross-sectional study of the Pediatric Health Information Systems database. All patients age <2 years admitted with bronchiolitis and discharged between January 1, 2010 and December 31, 2019, were included. Outcomes included proportions of annual ICU admissions, invasive mechanical ventilation (IMV), noninvasive ventilation (NIV), and cost. Results: Of 203 859 admissions for bronchiolitis, 39 442 (19.3%) were admitted to an ICU, 6751 (3.3%) received IMV, and 9983 (4.9%) received NIV. ICU admissions for bronchiolitis doubled from 11.7% in 2010 to 24.5% in 2019 ( P < .001 for trend), whereas ICU admissions for all children in Pediatric Health Information Systems <2 years of age increased from 16.0% to 21.1% during the same period ( P < .001 for trend). Use of NIV increased sevenfold from 1.2% in 2010 to 9.5% in 2019 ( P < .001 for trend). Use of IMV did not significantly change (3.3% in 2010 to 2.8% in 2019, P = .414 for trend). In mixed-effects multivariable logistic regression, discharge year was a significant predictor of NIV (odds ratio: 1.24; 95% confidence interval [CI]: 1.23-1.24) and ICU admission (odds ratio: 1.09; 95% CI: 1.09-1.09) but not IMV (odds ratio: 1.00; 95% CI: 1.00-1.00). Conclusions: The proportions of children with bronchiolitis admitted to an ICU and receiving NIV have substantially increased, whereas the proportion receiving IMV is unchanged over the past decade. Further study is needed to better understand the factors underlying these temporal patterns. Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. (Copyright © 2021 by the American Academy of Pediatrics.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu