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Archives de pédiatrie
Volume 25, n° 3
pages 189-193 (avril 2018)
Doi : 10.1016/j.arcped.2018.02.001
Received : 20 December 2016 ;  accepted : 2 February 2018
Research Papers

L’anémie, un nouveau facteur de sévérité de la bronchiolite aiguë du nourrisson ?
Anemia, a new severity factor in young infants with acute viral bronchiolitis?
 

G. Tourniaire a, C. Milési a, J. Baleine a, J. Crozier a, C. Lapeyre a, C. Combes a, N. Nagot b, G. Cambonie a,
a Département de pédiatrie néonatale et réanimations, centre hospitalier universitaire de Montpellier, hôpital Arnaud-de-Villeneuve, pôle hospitalo-universitaire femme-mère-enfant, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France 
b Département de l’information médicale, centre hospitalier universitaire de Montpellier, hôpital Arnaud-de-Villeneuve, pôle hospitalo-universitaire femme-mère-enfant, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France 

Auteur correspondant.
Abstract
Introduction

The role of anemia is raised as a risk of low respiratory infection of the child, but there are no data on anemia as a severity factor in acute viral bronchiolitis (AVB) in infants.

Methods

All infants less than 16 weeks old admitted to Montpellier University Hospital from 2015/10/01 to 2016/04/01 for AVB were included in a retrospective observational study. The primary objective was to determine whether the hemoglobin (Hb) concentration on admission was an independent factor of clinical severity, judged by the modified Wood's clinical asthma score (m-WCAS). The secondary objective was to assess the impact of Hb level on the characteristics of hospitalization, including the type and duration of respiratory support.

Results

The m-WCAS was used at least once during hospitalization in 180 out of 220 patients (82%), making it possible to distinguish patients with mild AVB (maximum m-WCAS<2, n =81) from patients with severe AVB (maximum m-WCAS>2, n =99). A logistic regression model indicated that the Hb concentration, for every 1g/dL decrement, was an independent factor of AVB severity (OR 1.16 [1.03–1.29], P =0.026). A level under 10g/dL on admission was associated with a higher use of continuous positive airway pressure (P <0.001), as well as a longer duration of respiratory support (P =0.01).

Conclusion

This study suggested that anemia may influence the clinical expression of AVB in young infants.

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Keywords : Acute viral bronchiolitis, Hemoglobin, Infant, Continuous positive airway pressure, Noninvasive ventilation




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