Real‐life comparison of three general paediatric wards showed similar outcomes for children with bronchiolitis despite different treatment regimens

• Published in: Acta Paediatrica 2017-09, Vol.106 (9), p.1507-1511
• Main Authors: Shmueli, Einat, Berger, Tal, Herman, Yonatan A., Chodick, Gabriel, Rom, Eran, Bilavsky, Efraim, Ashkenazi‐Hoffnung, Liat, Ashkenazi, Shai, Amir, Jacob, Prais, Dario
• Format: Article
• Language: English
• Subjects: Administration, Inhalation; Adrenergic beta-Agonists - administration & dosage; Anti-Bacterial Agents - therapeutic use; Bronchiolitis; Bronchiolitis - drug therapy; Bronchiolitis - epidemiology; Bronchopneumonia; Children; Clinical Protocols; Desaturation; Epinephrine; Epinephrine - administration & dosage; Female; Health care facilities; Humans; Infant; Infant, Newborn; Israel - epidemiology; Leukocytosis; Male; Multivariate analysis; Nebulised adrenalin; Nebulised hypertonic saline; Osmosis; Oxygen content; Respiratory syncytial virus; Retrospective Studies; Saline Solution, Hypertonic - administration & dosage; Saturation
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/apa.13921

Aim This study evaluated the effectiveness of three different treatments for bronchiolitis in a tertiary paediatric facility. Methods Patients with bronchiolitis who were younger than two years of age and were randomly allocated to three general wards at Schneider Children's Medical Center, Israel, after admission were included. Different treatment protocols in the wards were retrospectively compared. Results The study comprised 286 children. The clinical and laboratory parameters on admission were similar between the wards. In Ward C where nebulised hypertonic saline was infrequently administered (6.7%), the mean number of days with oxygen saturation under 92% and the meanlength of hospital stay (1.8 and 3.8 days) were significantly lower than Ward A (2.8 and 5.3 days) and Ward B, (2.9 and 4.7 days) where nebulised hypertonic saline was given more frequently (38.7%–74.7%). Multivariate analysis indicated that low saturation on admission, leukocytosis and use of nebulised hypertonic saline or adrenalin were independent predictors of a longer period of desaturation and hospital stay. Conclusion Different treatment protocols for bronchiolitis were used in three paediatric wards in this real‐life study. No treatment regimen proved superior. Inhalations of hypertonic saline or adrenaline were associated with a longer hospital stay.