Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units
on behalf of the PICE Study Group
(2021) European Journal of Pediatrics, volume 180, issue 10, pp. 3141 - 3149
(Article)
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 ≤
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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.
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Keywords: Airway management, Bronchiolitis, Child, High flow nasal cannula, Non-invasive ventilation, Respiratory syncytial viruses, Vaccination, Pediatrics, Perinatology, and Child Health, Journal Article
ISSN: 0340-6199
Publisher: Springer Verlag
Note: Funding Information: This work was supported by the Innovative Medicines Initiative 2 Joint Undertaking (to RESCEU, under grant agreement 116019). This Joint Undertaking receives support from the European Union’s Horizon 2020 Research and Innovation Program and the European Federation of Pharmaceutical Industries and Associations. Further funding by Janivo Foundation, the Netherlands, and the CJ Vaillant Foundation, the Netherlands. R. Linssen received an Amsterdam UMC PhD Scholarship. Funding Information: We wish to acknowledge Idse Visser, the working group for Clinical Virology of the Dutch Society for Medical Microbiology (Nederlandse Werkgroep Klinische Virologie, NWKV), Center of Infectious Diseases Control, National Institute of Public Health and Environment, as well as Anne Teirlinck and Ruben P.A. van Eijk. Collaborators: the Pediatric Intensive Care Evaluation (PICE) study group: Roelie M. W?sten-van Asperen, Richard H. Klein, Martin C.J. Kneyber, Jan Willem Kuiper, Carin Verlaat, Marc van Heerde, Maaike A. Riedijk, Dick A. van Waardenburg. Publisher Copyright: © 2021, The Author(s).
(Peer reviewed)