Document Detail

Clinical predictors of nasal continuous positive airway pressure requirement in acute bronchiolitis.
MedLine Citation:
PMID:  21901857     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: There is growing use of nasal continuous positive airway pressure ventilation (nCPAP) for infants with bronchiolitis, based on clinical assessment of severity. Despite this there have been no studies which identify clinical predictors for the requirement of nCPAP.
OBJECTIVE: To identify clinical factors in infants with acute bronchiolitis in the emergency department (ED), which might predict a requirement for nCPAP following admission.
MATERIALS AND METHODS: Retrospective review of pediatric ED case notes was conducted on bronchiolitis admissions to one dedicated Paediatric ED over a 12-month period. Potential predictors were identified through literature review. Data extraction of predictors was carried out and recorded for each case. Logistic regression was conducted for each variable to identify statistically significant predictors of nCPAP requirement.
RESULTS: Twenty-eight (17%) of the 163 admitted infants received nCPAP. The strongest predictors of nCPAP requirement in were as follows: oxygen requirement within the ED (P < 0.001), lower oxygen saturation (P < 0.001), younger age at presentation (P = 0.002), higher respiratory rate (P = 0.002), higher heart rate (P = 0.003), lower Glasgow Coma Scale score (0.006), and younger gestational age (P = 0.024).
CONCLUSION: We have identified clinical variables that were predictive of nCPAP requirement in infants admitted to our unit with bronchiolitis, oxygen requirement in the ED being the strongest single predictor. This is the first such study in the UK, and we hope it may be a starting point for further work that may provide an evidence base to aid clinicians in predicting the use of nCPAP in infants with bronchiolitis.
Jordan Evans; Matko Marlais; Ed Abrahamson
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Publication Detail:
Type:  Journal Article     Date:  2011-09-07
Journal Detail:
Title:  Pediatric pulmonology     Volume:  47     ISSN:  1099-0496     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-20     Completed Date:  2012-07-23     Revised Date:  2013-04-26    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  381-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Wiley Periodicals, Inc.
Department of Paediatric Emergency Medicine, Chelsea and Westminster Hospital, London, UK.
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MeSH Terms
Acute Disease
Age Factors
Bronchiolitis / therapy*
Coma / physiopathology
Continuous Positive Airway Pressure*
Gestational Age
Heart Rate / physiology
Oxygen / blood,  therapeutic use
Respiratory Rate / physiology
Retrospective Studies
Reg. No./Substance:
Comment In:
Pediatr Pulmonol. 2013 Apr;48(4):416   [PMID:  22821821 ]
Pediatr Pulmonol. 2013 Apr;48(4):415   [PMID:  22821842 ]

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