Infants under 6 months with bronchiolitis are most likely to need major medical interventions in the 5 days after onset

Aim This study examined the need for, and timing of, major medical interventions (MMIs) in infants under 6 months of age with bronchiolitis. Methods We reviewed the medical records of 353 children who visited our emergency department with bronchiolitis. MMI was defined as the need for any of the following interventions during admission: supplementary oxygen, intravenous fluids, intravenous antibiotics or admission to the intensive care unit. Results Altogether 19% of the 353 patients required a MMI and 3% had apnoea. The patients with apnoea were all under 2 months of age, and 90% had a respiratory syncytial virus (RSV) infection and 40% had been born prematurely. The risk of needing a MMI continued for up to 5 days after disease onset. A positive RSV test predicted a MMI with an odds ratio (OR) of 11.5 (95% CI 2.6–50.5), and a fever of over 38°C predicted a MMI with an OR of 3.5 (95% CI 1.4–8.8). Each 1% increase in the initial oxygen saturation value was associated with a decreased risk of MMI (OR 0.7, 95% CI 0.6–0.8). Conclusion Infants under 6 months of age with bronchiolitis were most likely to need MMIs in the first 5 days after disease onset.