Differences of Medical Care for Acute Severe Viral Bronchiolitis in Two Urban Areas in Europe.

Abstract

Acute viral bronchiolitis is a frequent disease in infancy. There is little knowledge on medical care of severely affected infants in different European countries. Infants (n=146) with bronchiolitis requiring respiratory support in winter season 2015/2016 treated in either one of two regions in Central Europe: South of greater Paris region in France (group 1) and Ruhr area in Germany (group 2). Retrospective chart review. Primary outcome parameter was duration of respiratory support. Infants in group 1 (n=96) were younger, suffered less frequently from neurologic disorders and had lower respiratory rates than in group 2 (n=50). CO2 levels and dyspnea score were similar. Ninety percent of infants in group 1 were treated by nasal Continuous Airway Pressure CPAP, while 80% of infants in group 2 were treated by High Flow Nasal Cannula HFNC. Duration of respiratory support was significantly shorter in group 1. Infants in group 2 received more frequently infusion therapy, more antibiotics and more inhalation therapy. Our results show better outcome for infants with viral bronchiolitis treated in France. Striking differences were the practice of respiratory support (nasal CPAP vs. HFNC) and the prescription of supportive treatments. Treatment approaches in severe acute viral bronchiolitis differ widely between a French and a German urban region.