Methods: Retrospective chart review of patients admitted to the PICU due to severe acute bronchiolitis between 01.08.2018-01.11.2019 were included in to the study.
Results: One hundred and five patients were enrolled. High flow nasal cannula was used in 70 patients (66.6%), non-invasive ventilation (spontaneous/time mode) was used in 19 (18.1%) patients and invasive mechanical ventilation was used in 16 (15.3%) patients. Birth weight (Odds Ratio [OR]:0.99), admission weight (OR:0.749), age in months (OR:0.763), history of prematurity (OR:3.06), presence of chronic respiratory diseases (OR:4.61), presence of chronic cardiac diseases (OR:3.23) and respiratory syncytial virus infection (OR:4.37) were significant for intubation requirement in logistic regression analysis. Age ≤4 months (sensitivity: 50% specificity: 85.3%) and birth weight ≤3000 g (sensitivity: 75% specificity: 75.8%) were found significant in receiver operating characteristics curve analysis.
Conclusion: Invasive mechanical ventilation in severe acute bronchiolitis is a challenging process that requires experience. History of prematurity without chronic lung disease appears not to be a significant risk factor for intubation. Patients with chronic lung disease, low birth weight, history of prematurity especially when these are complicated with RSV infection should be transferred to experienced centers in the early period.
Keywords : Bronchiolitis, artificial respiration, infant, critical care