Treatment of severe bronchiolitis: A survey of Canadian pediatric intensivists

Pediatric Pulmonology
Matthew L BradshawPatricia S Fontela

Abstract

To describe management practices and the factors guiding admission and treatment decisions for viral bronchiolitis across Canadian pediatric intensive care units (PICUs). Cross-sectional survey. Canadian PICUs. Pediatric intensivists. A survey using two case scenarios (non-intubated vs intubated patients) was developed using focus groups and a literature review. We analyzed our results using descriptive statistics and multivariate logistic regression. Our response rate was 55% (57/103). Regarding bronchiolitis management, 75% (42/56) of respondents would use inhaled therapies, with nebulized epinephrine (33/56, 59%) and salbutamol (20/56, 36%) being the most common. Antibiotic use within the first hour of admission to PICU almost doubled in frequency (36% vs 71%) in patients who required mechanical ventilation (p 0.0004). High flow nasal cannula (HFNC; 32/56, 57%) and continuous positive airway pressure (CPAP; 16/56, 29%) were the preferred modes of non-invasive ventilation (NIV). The management of severe viral bronchiolitis is similar across Canadian PICUs. The use of NIV, inhaled treatments, and antibiotics is frequent, which differs from the recommendations made by published guidelines. Canadian pediatric intensivists use ho...Continue Reading

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Citations

May 17, 2018·European Journal of Pediatrics·Minna MecklinMatti Korppi
Nov 30, 2018·Expert Review of Respiratory Medicine·Matti Korppi
Oct 26, 2018·Expert Opinion on Pharmacotherapy·Maria Gabriella MateraMario Cazzola
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Aug 21, 2020·Pediatric Pulmonology·Elise DelacroixGuillaume Mortamet
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Feb 6, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Reinout A Bem
Mar 4, 2021·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Reinout A Bem, Job B M van Woensel

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