G386(P) Bronchiolitis: 10 year experience of infants ventilated in a regional paediatric intensive care unit

Abstract

Bronchiolitis is a common cause of respiratory illness in children resulting in significant pressures on health services. Hospitalisation occurs in up to 3.5% of cases and 10% of these will require admission to the paediatric intensive care unit (PICU). Aim To review the patient characteristic’s for all infants (less than 1 year old) who were admitted to the regional PICU requiring invasive ventilation for bronchiolitis, over the 10 year period from 1st January 2003 to 31st December 2012. Method Data was retrospectively collected for all infants admitted to the regional PICU from PICANet data, the retrieval database and discharge letters were then reviewed. A range of data was collected including gestational age, age at presentation, presence of apnoeas, length of ventilation, length of stay, Respiratory syncytial virus status, use of inotropes and pre-existing diagnoses (particularly congenital heart disease and chronic lung disease). Results 256 infants were invasively ventilated, there were 4 deaths (all had significant co-morbidities). 82% of admissions were between November and January. There was a male predominance and two thirds of the infants ventilated were less than 2 months at presentation. The Mean length of PICU stay was 8 days and mean number of days ventilated 6. 16% of patients required inotropic support. Interestingly 43% of infants with congenital heart disease who were ventilation for bronchiolitis required inotropes. As found by previous studies, apnoea was a common feature, this was associated with prematurity (64% of infants Conclusion This study highlights high seasonal pressure on PICU of bronchiolitis and that apnoeas are a significant risk factor for PICU admission. It also shows that although bronchiolitis is commonly thought to be a single organ disease, it can have cardiovascular consequences.