1. Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units
- Author
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Linssen, Rosalie S., Bem, Reinout A., Kapitein, Berber, Rengerink, Katrien Oude, Otten, Marieke H., den Hollander, Bibiche, Bont, Louis, van Woensel, Job B. M., Wösten-van Asperen, Roelie M., Klein, Richard H., Kneyber, Martin C. J., Kuiper, Jan Willem, Verlaat, Carin, van Heerde, Marc, Riedijk, Maaike A., van Waardenburg, Dick A., Paediatric Intensive Care, AII - Infectious diseases, ARD - Amsterdam Reproduction and Development, Paediatric Metabolic Diseases, APH - Personalized Medicine, RS: NUTRIM - R1 - Obesity, diabetes and cardiovascular health, Kindergeneeskunde, and MUMC+: MA Medische Staf Kindergeneeskunde (9)
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,INFANTS ,CHILDREN ,Airway management ,Respiratory Syncytial Virus Infections ,medicine.disease_cause ,Intensive Care Units, Pediatric ,DISEASE ,OXYGEN ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,Intensive care ,medicine ,Cannula ,Humans ,Respiratory system ,Child ,Retrospective Studies ,Mechanical ventilation ,Pediatric intensive care unit ,Respiratory syncytial viruses ,business.industry ,Vaccination ,Infant ,medicine.disease ,PREVENTION ,High flow nasal cannula ,INTUBATION ,Bronchiolitis ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Breathing ,Non-invasive ventilation ,Original Article ,business ,Nasal cannula - Abstract
Respiratory syncytial virus (RSV) bronchiolitis causes substantial morbidity and mortality in young children, but insight into the burden of RSV bronchiolitis on pediatric intensive care units (PICUs) is limited. We aimed to determine the burden of RSV bronchiolitis on the PICUs in the Netherlands. Therefore, we identified all children ≤ 24 months of age with RSV bronchiolitis between 2003 and 2016 from a nationwide PICU registry. Subsequently we manually checked their patient records for correct diagnosis and collected patient characteristics, additional clinical data, respiratory support modes, and outcome. In total, 2161 children were admitted to the PICU for RSV bronchiolitis. The annual number of admissions increased significantly during the study period (β 4.05, SE 1.27, p = 0.01), and this increase was mostly driven by increased admissions in children up to 3 months old. Concomitantly, non-invasive respiratory support significantly increased (β 7.71, SE 0.92, p < 0.01), in particular the use of high flow nasal cannula (HFNC) (β 6.69, SE 0.96, p < 0.01), whereas the use of invasive ventilation remained stable.Conclusion: The burden of severe RSV bronchiolitis on PICUs has increased in the Netherlands. Concomitantly, the use of non-invasive respiratory support, especially HFNC, has increased. What is Known:• RSV bronchiolitis is a major cause of childhood morbidity and mortality and may require pediatric intensive care unit admission.• The field of pediatric critical care for severe bronchiolitis has changed due to increased non-invasive respiratory support options. What is New:• The burden of RSV bronchiolitis for the Dutch PICUs has increased. These data inform future strategic PICU resource planning and implementation of RSV preventive strategies.• There was a significant increase in the use of high flow nasal cannula at the PICU, but the use of invasive mechanical ventilation did not decrease.
- Published
- 2021
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