The Clinical Management of Preterm Infants With Bronchiolitis
| Autor: | Brian Alverson, Elizabeth Dawson-Hahn, Sarah E. Smitherman, Kristin Koehn, Russell J. McCulloh |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty MEDLINE Subgroup analysis Respiratory Syncytial Virus Infections Cohort Studies Adrenal Cortex Hormones Risk Factors Influenza Human Outcome Assessment Health Care Racepinephrine medicine Humans Albuterol Practice Patterns Physicians' Retrospective Studies Racemic epinephrine business.industry Infant Newborn Case-control study Infant Retrospective cohort study General Medicine medicine.disease Anti-Bacterial Agents Bronchodilator Agents Bronchiolitis Case-Control Studies Pediatrics Perinatology and Child Health Female Diagnosis code Blood Gas Analysis business Infant Premature Cohort study medicine.drug |
| Zdroj: | Hospital Pediatrics. 3:244-250 |
| ISSN: | 2154-1671 2154-1663 |
| DOI: | 10.1542/hpeds.2012-0071 |
| Popis: | Objectives:The goal of this study was to determine physician management choices for hospitalized premature infants with bronchiolitis compared with term infants and to evaluate predictors of steroid use in premature infants.Methods:A chart review was conducted of premature and nonpremature infants admitted to 2 children’s hospitals with bronchiolitis. Reviewers selected charts based on International Classification of Diseases, Ninth Revision diagnosis codes and collected demographic and historical information, as well as evaluation, treatment, treatment effectiveness, length of stay, hospital readmission rates, and adverse outcomes. Reviewers compared documented rates of utilization and effectiveness of inhaled racemic epinephrine and albuterol between patients with and without a history of prematurity. Patients with a history of prematurity underwent subgroup analysis of factors relating to steroid use.Results:A total of 1223 patients met the study criteria for inclusion. Premature infants represented 19% of all children hospitalized with bronchiolitis. These infants had a longer length of stay (3.8 vs 2.6 days; P < .001) and a more severe hospital course. Rates of inhaled therapy and steroid utilization did not differ between premature and term infants. There was no difference in rates of documented positive response to albuterol, but premature infants were more likely to have a positive response to epinephrine. Steroid use in premature infants was associated with older age, history of wheeze, and albuterol use; documentation of albuterol efficacy did not correlate with steroid use, however.Conclusions:Management decisions among term and premature infants with bronchiolitis were similar. Premature infants who received albuterol were more likely to receive steroids; however, the decision regarding steroid use was not associated with documentation of efficacy of albuterol. |
| Databáze: | OpenAIRE |
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