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 - 15/12/20

Doi : 10.1016/j.arcped.2020.11.006

E. Delacroix ^a, A. Millet ^a, I. Wroblewski ^a, A. Vilotitch ^b, I. Pin ^c, A. Ego ^b, T. Debillon ^d, G. Mortamet ^a,⁎
^a Pediatric Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France
^b Public Health Department, Grenoble Alpes University Hospital, Grenoble, France
^c Pediatric Department, Grenoble Alpes University Hospital, Grenoble, France
^d Neonatology Intensive Care Unit, Grenoble Alpes University Hospital, Grenoble, France

^⁎Corresponding author. Pediatric Intensive Care Unit, CHU de Grenoble Alpes, Grenoble, France.Pediatric Intensive Care Unit, CHU de Grenoble AlpesGrenobleFrance

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 15 December 2020
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Abstract

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

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

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

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.

Le texte complet de cet article est disponible en PDF.

Keywords : Acute respiratory failure, Bronchiolitis, High-flow nasal cannula, Infants, Noninvasive ventilation