Rechercher
image du produit
Journal of Pediatrics, The

S'abonner

Predictors of Intensive Care Admission in Hypoxemic Bronchiolitis Infants, Secondary Analysis of a Randomized Trial - 05/05/23

Doi : 10.1016/j.jpeds.2022.12.006 
Donna Franklin, PhD, BN, MBA 1, 2, 3, 4, 5, ⁎ , Franz E. Babl, MD, MPH, FAAP, FRACP, FACEP 5, 6, 7, 8, Jocelyn Neutze, MBChB, FRACP, FACEM 5, 9, 10, Simon Craig, MBBS, FACEM, MHPE, MPH 5, 11, 12, Ed Oakley, MBBS, FACEM 5, 6, 7, 8, Jeremy Furyk, MBBS, MPH&TM, MSc, FACEM 5, 13, Chris M. Frampton, PhD 14, Nadia Hasan, MBBS 4, 15, Trang MT. Pham, BEng, MEng 4, Letitia Miller, BN 15, John F. Fraser, MBChB, PhD, FRCP (Glas), FRCA, FFARCSI, FCICM 16, 17, 18, Stuart R. Dalziel, MBChB, FRACP, PhD 5, 19, Andreas Schibler, MD, FCICM 5, 16, 17, 18

A Pediatric Acute Respiratory Intervention Study (PARIS) on behalf of PREDICT

1 Gold Coast University Hospital, Children's Emergency and Critical Care Collaborative Research Group, Southport, Australia 
2 Gold Coast University Hospital, Children's Critical Care, Southport, Australia 
3 Menzies Health Institute Queensland, Griffith University, Australia 
4 The University of Queensland, Faculty of Medicine, Brisbane, Australia 
5 Paediatric Research in Emergency Departments International Collaborative (PREDICT), Melbourne, Victoria, Australia 
6 Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia 
7 Murdoch Children's Research Institute, Melbourne, Victoria, Australia 
8 Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia 
9 Departments of Surgery and Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand 
10 KidzFirst Middlemore Hospital, Auckland, New Zealand 
11 Department of Paediatrics, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia 
12 Emergency Department, Monash Medical Centre, Melbourne, Australia 
13 Emergency Department, University Hospital Geelong, Victoria, Australia 
14 Department of Medicine, University of Otago Christchurch, New Zealand 
15 Queensland Children's Hospital, South Brisbane, Australia 
16 St Andrew's War Memorial Hospital, Brisbane, Australia 
17 Critical Care Research Group, St Andrew's War Memorial Hospital, Brisbane, Australia 
18 Wesley Medical Research, Auchenflower, Queensland, Australia 
19 Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand 

∗Reprint requests: Donna Franklin, PhD, BN, MBA, Gold Coast University Hospital and Menzies Health Institute of Queensland, Griffith University and The University of Queensland, 1 Hospital Bld Southport, Queensland, Australia.Gold Coast University Hospital and Menzies Health Institute of QueenslandGriffith University and The University of Queensland1 Hospital Bld SouthportQueenslandAustralia

Abstract

Objectives

To evaluate in a preplanned secondary analysis of our parent randomized controlled trial predictors of intensive care unit (ICU) admission in infants with bronchiolitis and analyze if these predictors are equally robust for children receiving high-flow or standard-oxygen.

Study design

A secondary analysis of a multicenter, randomized trial of infants aged <12 months with bronchiolitis and an oxygen requirement was performed using admission and outcome data of all 1472 enrolled infants. The primary outcome was ICU admission. The predictors evaluated were baseline characteristics including physiological data and medical history.

Results

Of the 1472 enrolled infants, 146 were admitted to intensive care. Multivariate predictors of ICU admission were age (weeks) (OR: 0.98 [95% CI: 0.96-0.99]), pre-enrolment heart rate >160/min (OR: 1.80 [95% CI: 1.23-2.63]), pre-enrolment SpO2 (transcutaneous oxygen saturation) (%) (OR: 0.91 [95% CI: 0.86-0.95]), previous ICU admission (OR: 2.16 [95% CI: 1.07-4.40]), and time of onset of illness to hospital presentation (OR: 0.78 [95% CI: 0.65-0.94]). The predictors were equally robust for infants on high-flow nasal cannula therapy or standard-oxygen therapy.

Conclusion

Age <2 months, pre-enrolment heart rate >160/min, pre-enrolment SpO2 of <87%, previous ICU admission and time of onset of ≤2 days to presentation are predictive of an ICU admission during the current hospital admission of infants with bronchiolitis independent of oxygenation method used.

Trial registration

ACTRN12613000388718.

Le texte complet de cet article est disponible en PDF.

Keywords : intensive care admission, predictors in bronchiolitis

Abbreviations : HFNC, PICU, SpO2


Plan


 The study is funded by a project grant from the National Health and Medical Research Council (NHMRC, GNT1081736 and GNT1058560), Canberra, Australia, and Queensland Emergency Medical Research Fund (QEMRF), Brisbane, Australia. The high-flow equipment and consumables for all study sites were provided free of charge by Fisher & Paykel Healthcare (Auckland, New Zealand). D.F., S.D., and A.S. report receiving travel support from Fisher and Paykel Healthcare, Auckland, New Zealand. The other authors declare no conflicts of interest.


© 2022  Elsevier Inc. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

    •

  • Contenu

    •

Vol 256

P. 92 - mai 2023 Retour au numéro
Article précédent Article précédent
  • Relationship Between Feeding to Sleep During Infancy and Subsequent Childhood Disease Burden
  • Eun Kyo Ha, Ju Hee Kim, Hye Ryeong Cha, Won Seok Lee, Seung Won Lee, Man Yong Han
| Article suivant Article suivant
  • Diagnostic Performance and Patient Outcomes With C-Reactive Protein Use in Early-Onset Sepsis Evaluations
  • Miren B. Dhudasia, William E. Benitz, Dustin D. Flannery, Lori Christ, David Rub, Giulia Remaschi, Karen M. Puopolo, Sagori Mukhopadhyay

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Accès rapides

Mon compte

Aide & support

Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.

Tout le contenu de ce site: Copyright © 2024 Elsevier, ses concédants de licence et ses contributeurs. Tout les droits sont réservés, y compris ceux relatifs à l'exploration de textes et de données, a la formation en IA et aux technologies similaires. Pour tout contenu en libre accès, les conditions de licence Creative Commons s'appliquent.