P0204 / #998: OUTCOME OF NEONATES REFERRED TO COMET WITH A PRELIMINARY DIAGNOSIS OF SEVERE BRONCHIOLITIS – AN UPDATE

Abstract

Aims & Objectives: Bronchiolitis accounts for a significant number of intensive care transfers. Our initial study established that many neonates referred with the initial diagnosis of bronchiolitis had an alternate diagnosis. However, majority of the ones with final diagnosis of Bronchiolitis had a virus isolated from nasopharyngeal aspirate (NPA). CoMET (Children’s Medical Emergency Transport) is a Paediatric Intensive Care transport service in the UK. We wanted to re-evaluate the outcome of neonates requiring intensive care transfers with the referral diagnosis of bronchiolitis. Methods: We studied all neonatal referrals to CoMET with diagnosis of bronchiolitis from the end of our last study till December 2019. Transport data log and discharge documents were reviewed. Results: Our initial study showed that out of 19 neonates with referral diagnosis of Bronchiolitis 8 (42%) had a final diagnosis of Bronchiolitis; 7 out of these 8 babies (88%) had a positive NPA. Eleven babies (58%) had alternative diagnosis including three with congenital heart disease and 8 with non-viral infections. Follow up study showed six among thirty (20%) neonates referred with bronchiolitis had an alternative final diagnosis. Out of these six neonates, 5 (16%) had non-viral infections including potentially serious infections such as meningitis/encephalitis and one had Spinal Muscular Atrophy SMA Type 1. Of the 24 with a discharge diagnosis of bronchiolitis, 22 (92%) had a viral organism isolated from nasopharyngeal aspirate (NPA). Conclusions: Positive NPA, for a viral organism, suggests bronchiolitis. If negative, another diagnostic possibility should be strongly considered.