Evaluation of Infants Hospitalized in Intensive Care Unit Due to Acute Severe Bronchiolitis in Terms of Recurrent Wheezing or Asthma Development

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Objective: Bronchiolitis stands out as the most prevalent lower respiratory tract infection among young children. Severe bronchiolitis, or bronchiolitis requiring admission to the hospital, affects 2-3% of all infants. The aim of this study was to evaluate individuals who were followed up in the pediatric intensive care unit (PICU) due to severe bronchiolitis in terms of asthma development. Material and Methods: Patients who were admitted Ankara Bilkent City Hospital PICU between January 2013 and December 2022, who were diagnosed with severe bronchiolitis and who had no additional systemic disease were included in the study. Demographic and clinical characteristics of patients, intensive care support treatments, duration of hospital stays, atopic conditions, and respiratory viral panel cultures was documented. The current clinical condition of the patients was documented through hospital records and telephone interviews conducted with their caregivers. The existence of asthma symptoms and the utilization of treatments within the last 12 months were evaluated according to the guidelines of the Global Initiative for Asthma (GINA) and the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Results: The mean age of the 60 patients admitted to the intensive care unit who met the study criteria was 13.5±7.2 months. The mean age of the children at the time of the study was 42.5 months. Male gender was more predominant (n=39, 65%). The mean number of days that respiratory support was received in intensive care was 4.9 (±3.5) days and the mean number of days of systemic steroid therapy was 3.8 (±1.7) days. In the viral respiratory tract, Respiratory Syncytial Virus (RSV) was isolated at the highest frequency in 27 patients, accounting for 45%, followed by rhinovirus (n=6, 10%) and Bocavirus (n=5, 8.3%). The number of patients receiving current asthma treatment was (n=33, 55%). Upon assessing the current status, it was found that there had been 25 (41.6%) patients with asthma attacks over the past 12 months. Conclusion: This study revealed that over half of the patients who experienced severe bronchiolitis subsequently developed asthma, with some not being referred to an allergy clinic. Furthermore, it was observed that certain patients, despite presenting with asthma symptoms, were unaware that these symptoms were attributable to asthma. We recommend that patients admitted to the PICU with a diagnosis of severe bronchiolitis be closely monitored for the potential development of asthma and that families be thoroughly informed at the time of discharge.