P0302 / #2082: SECOND-HAND SMOKE EXPOSURE: HOW DOES IT AFFECT OUR INFANTS?

Abstract

Aims & Objectives: To investigate the effect of tobacco smoke exposure among severely pediatric intensive care unit (PICU) patients. Methods: A prospective epidemiological observational study was conducted among children with bronchiolitis younger than 2 years of age admitted to a PICU in a tertiary hospital in Madrid, Spain, during the October 2017 to March 2018 outbreak. On admission, parents were asked whether they smoked. In children who required invasive mechanical ventilation, endotracheal aspirate was collected at the time of intubation. Main outcome measures included: need for invasive mechanical ventilation (IMV), pulmonary bacterial infection (PBI) and PICU length of stay. Results: A total of 102 patients with bronchiolitis were studied. Among these, 14 (47%) of 30 infants whose parents smoked required invasive mechanical ventilation vs. 14 (19%) of 72 whose parents were nonsmokers (p=0.007) (RR 2.4; 95% CI 1.3–4.4). Among patients on invasive mechanical ventilation, 10 (71%) of 14 infants with secondhand smoke exposure presented PBI vs. 3 (21%) of 14 in the unexposed (p=0.012) (RR 3.3; 95% CI 1.2–9.6). PICU stay was 3 (IQR 3-6) days in infants whose parents didn´t smoke, and 5 (IQR 3-11) days in infants whose parents smoked (p=0.01). Conclusions: Secondhand smoke exposure is an additional high risk for PBI, IMV, and PICU length of stay, in infants with severe acute bronchiolitis.