P0382 / #705: SEVERE BRONCHIOLITIS IN 13 PICUS FROM URUGUAY: COMPARATIVE ANALYSIS ON EPIDEMIOLOGY, PATTERNS OF CARE AND OUTCOMES WITH OTHER LATIN-AMERICAN UNITS FROM A MULTICENTER REGISTRY

Abstract

Aims & Objectives: To compare the epidemiology, therapeutic management and clinical outcomes of infants with bronchiolitis admitted to 13 PICUs from Uruguay (UY) using a multinational Latin-American (LATAM) PICU cohort. Methods: Retrospective analysis using prospectively collected clinical data within LARed Network Acute Respiratory Failure registry (35 hospitals, 8 LATAM countries) of all infants admitted with diagnosis of Bronchiolitis (older 1mo and younger than 2ys) from May 2017 to April 2019. We divided 2 groups for comparative analysis: UY and LATAM. Demographics, clinical data, respiratory support, adjuvant therapies and outcomes were analyzed. Results: 1510 eligible hospitalizations were analyzed: 666 from UY and 840 from LATAM. Groups had similar ages, weights, etiology and comorbidities. LATAM infants had higher severity scores at admission. Bronchodilators and steroids were more frequently used in UY and nebulized epinephrine and hypertonic saline in LATAM. There was a high antibiotic use in LATAM (58.2%) and UY (51.5%) p<0.01) (Fig.1). Respiratory support was mainly noninvasive, and invasive ventilation related complications where higher in UY (21.3% vs 12.2%, p 0.05) (Fig. 1). There were no differences on days of stay (4.5 in UY vs 5.1 LATAM) neither mortality in PICU (0.3 UY vs 0.5% LATAM), but less new morbidities in UY (0.2% vs 4.1%, p<0.001).Conclusions: In Uruguay, severity of Bronchiolitis was lower and respiratory support predominantly noninvasive compared with LATAM. The higher rate of IMV-related complications in Uruguay and the high use of therapies leading to similar outcomes probably indicates overuse. Quality initiatives are needed to improve resource allocation.