Clinical and epidemiological profile of infants admitted to an intensive care unit for acute viral bronchiolitis in Brazil

Abstract

Acute viral bronchiolitis (AVB) is a frequent respiratory disease in infants, responsible for high morbidity and high hospitalization rates. It has an epidemic pattern prevalent in winter and spring. The most common pathogen is the respiratory syncytial virus. The decision for intensive care unit admission depends on indicators of disease severity, which include: severe dehydration, tachypnea with exertion, wheezing, cyanosis or hypoxemia, altered neurological status. In some cases, bronchiolitis may complicate respiratory failure and require ventilatory support. Another important consideration at the time of admission decision is the presence of comorbidities such as heart disease, extreme prematurity, immunodeficiency, and neuropathy that often lead to unfavorable outcomes. In addition to paying attention to young infants younger than 3 months, who have a worse prognosis and higher mortality rate. In such cases, close medical attention should be sought, with supportive measures necessary for a better outcome of the case. In an intensive care unit in Brazil, after the establishment of a therapeutic protocol for bronchiolitis, favorable results were observed with the use of hypertonic saline, infrequent use of corticosteroids and antibiotics, even in infants who required ventilatory support.