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Incidence and predisposing factors for severe disease in previously healthy term infants experiencing their first episode of bronchiolitis

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Abstract Aim: 

To determine the incidence and predisposing factors for severe bronchiolitis in previously healthy term infants <12 months of age experiencing their first episode of bronchiolitis. Methods: 

Epidemiological, clinical and virological data were prospectively collected. Severity was assessed by the need for ventilatory support. Results: 

Of the 310 infants enrolled, 16 (5.1%) presented with severe bronchiolitis requiring ventilatory support (11 since admission). Compared with infants with less severe bronchiolitis, infants with severe disease presented with lower birth weight, gestational age, postnatal weight and postnatal age, and were more likely to be born by cesarian section. C-reactive protein positive results (>0.8 mg/dL) and pulmonary consolidation on chest X-ray were more common among infants with severe disease. Severity was independently associated with younger age on admission <30 days, respiratory syncytial virus (RSV) infection and lymphocyte counts <3200/μL. No significant differences were found between epidemiologic variables. Conclusions: 

Severe bronchiolitis is uncommon in previously healthy term infants <12 months of age and when present develops soon after disease onset. Severity is predicted by young age and RSV carriage, whereas epidemiologic variables seem less likely to intervene.
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Keywords: Bronchiolitis; Mechanical ventilation; Noninvasive ventilation; Paediatric intensive care unit; Previously healthy term infants; Respiratory viruses; Risk factors

Document Type: Research Article

Affiliations: 1:  Pediatric Emergency and Intensive Care, Department of Pediatrics, Sapienza University of Rome, Rome, Italy 2:  Biostatistics, Department of Pediatrics, Sapienza University of Rome, Rome, Italy 3:  Pediatric Radiology, Department of Pediatrics, Sapienza University of Rome, Rome, Italy 4:  Virology Section, Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

Publication date: 2011-07-01

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