SciELO - Scientific Electronic Library Online

 
vol.37 issue2Flavour additives and design lettering in cigarettes and tobacco products available close to educational centers in Montevideo, UruguayClinical and epidemiological profile and functionality achieved in patients with traumatic spinal cord injury assisted at the Rehabilitation and Physical Medicine Service at the University Hospital author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Related links

Share


Revista Médica del Uruguay

Print version ISSN 0303-3295On-line version ISSN 1688-0390

Abstract

MARTINEZ-ARROYO, Luis et al. Bronchiolitis admissions in 13 pediatric intensive care units in Uruguay: is it the same in Montevideo (capital city) and the provinces?. Rev. Méd. Urug. [online]. 2021, vol.37, n.2, e206.  Epub June 01, 2021. ISSN 0303-3295.  https://doi.org/10.29193/rmu.37.2.6.

Objectives:

to describe the clinical and epidemiological characteristics of children admitted for bronchiolitis in 13 Pediatric Intensive Care Units (UCIP) in Uruguay and compare the final care outcomes between Montevideo (UM) and Interior of the country (IU).

Method:

multicenter, retrospective, observational study of data entered in the LARed Network prospective database. Children over 1 month and younger than 2 years admitted between May 1, 2017 and April 30, 2019 with a diagnosis of Community Bronchiolitis were included in the study. Demographic and clinical data were analyzed, as well as interventions and discharge outcomes.

Results:

666 cases were analyzed. No significant differences in comorbidity and respiratory support were detected at admission. In IU patients were referred more frequently from another hospital. The distance and average time, as well as the percentage of transfers greater than 50 km, was also higher. In IU, patients had greater clinical and gasometrical severity at admission. The radiological and etiological profile was similar (VRS at > 50%). The overall indication of corticosteroids exceeded 25% and that of bronchodilators exceeded 85%. The prescription for antibiotics and nebulized adrenaline was higher in IU. The high flow nasal cannula (HFNC) was globally the most widely used respiratory support method, although increased use of invasive mechanical ventilation (IMV) and CPAP in IU (43% vs 28% in UM) was observed. There were no differences in the number of complications from IVF or non-invasive ventilation, nor in the use of rescue therapies. There were also no significant differences in the length of stay at UCIP or in absolute and adjusted mortality and there was only one case of new morbidity.

Conclusions:

children admitted to IU had higher severity scores and more transfer-related risk factors, received more antibiotics and invasive support. HFNC was the most widely used type of respiratory support in the country. A high prescription of non-recommended therapies such as bronchodilators and corticosteroids was detected. Mortality and complications were low, as were the generation of new morbidity.

Keywords : Bronchiolitis; Intensive Care Units, Pediatric; Noninvasive ventilation; Morbidity; Child; High flow nasal cannula.

        · abstract in Spanish | Portuguese     · text in Spanish     · Spanish ( pdf )