Bronchiolitis: evidence-based management in high-risk infants in the intensive care setting
Aim Systematically review the management of infants with severe bronchiolitis in a paediatric intensive care unit (PICU) setting with a focus on high-risk infants to identify gaps in evidence-based knowledge. Methods This systematic review utilised Preferred Reporting Items for Systematic Review and...
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| Veröffentlicht in: | Pediatric research 2024-06, Vol.96 (7), p.1560-1567 |
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| container_title | Pediatric research |
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| creator | Walsh, Ruth Costello, Liam DiCosimo, Alexandria Doyle, Anne-Marie Kehoe, Laura Mulhall, Cormac O’Hara, Sean Elnazir, Basil Meehan, Judith Isweisi, Eman Semova, Gergana Branagan, Aoife Roche, Edna Molloy, Eleanor |
| description | Aim
Systematically review the management of infants with severe bronchiolitis in a paediatric intensive care unit (PICU) setting with a focus on high-risk infants to identify gaps in evidence-based knowledge.
Methods
This systematic review utilised Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) to examine the literature on the PICU management of bronchiolitis in infants |
| doi_str_mv | 10.1038/s41390-024-03340-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11772224</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3070839500</sourcerecordid><originalsourceid>FETCH-LOGICAL-c426t-798614a20655222bb286b561ed4025768b4d4edd7807ac3b749342c5c1f2a2773</originalsourceid><addsrcrecordid>eNp9UcmO1DAQtRCIaRp-gAOKxIWLobzFDhcEIzZpJC5w4mA5TnXiIXEG291S_z0eehiWA6dSVb33anmEPGbwnIEwL7JkogMKXFIQQgI93iEbpkQtSanvkg2AYFR0nTkjD3K-BGBSGXmfnAnTVZaSG_L1TVqjn8I6hxLyywYPYcDokfYu49AsLroRF4ylCbGZwjjRFPK3muxcLPm6WCasoWDM4YCNdwmbjKWEOD4k93ZuzvjoJm7Jl3dvP59_oBef3n88f31BveRtobozLZOOQ6sU57zvuWl71TIcJHClW9PLQeIwaAPaedFr2QnJvfJsxx3XWmzJq5Pu1b5fcPB12-Rme5XC4tLRri7YvzsxTHZcD5YxretEWRWe3Sik9fsec7FLyB7n2UVc99kK0GBEp-pDt-TpP9DLdZ9ivc8K1gLnjHemovgJ5dOac8Ld7TYM7LV59mSerTbYn-bZYyU9-fOOW8ovtypAnAC5tuKI6ffs_8j-AHXppXw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3160221298</pqid></control><display><type>article</type><title>Bronchiolitis: evidence-based management in high-risk infants in the intensive care setting</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Walsh, Ruth ; Costello, Liam ; DiCosimo, Alexandria ; Doyle, Anne-Marie ; Kehoe, Laura ; Mulhall, Cormac ; O’Hara, Sean ; Elnazir, Basil ; Meehan, Judith ; Isweisi, Eman ; Semova, Gergana ; Branagan, Aoife ; Roche, Edna ; Molloy, Eleanor</creator><creatorcontrib>Walsh, Ruth ; Costello, Liam ; DiCosimo, Alexandria ; Doyle, Anne-Marie ; Kehoe, Laura ; Mulhall, Cormac ; O’Hara, Sean ; Elnazir, Basil ; Meehan, Judith ; Isweisi, Eman ; Semova, Gergana ; Branagan, Aoife ; Roche, Edna ; Molloy, Eleanor</creatorcontrib><description>Aim
Systematically review the management of infants with severe bronchiolitis in a paediatric intensive care unit (PICU) setting with a focus on high-risk infants to identify gaps in evidence-based knowledge.
Methods
This systematic review utilised Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) to examine the literature on the PICU management of bronchiolitis in infants <24 months old. Three databases, Embase, PubMed and Medline, were searched and higher levels of evidence I, II and III were included.
Results
There were 455 papers reviewed and 26 met the inclusion criteria. Furthermore, 19 of these studied respiratory interventions such as positive airway pressure and oxygen delivery. The remaining 7 examined: erythropoietin, caffeine, dexamethasone, protein supplementation, ribavirin, respiratory syncytial virus immune globulin, or diuretic therapy. Of the 26 studies, 20 excluded infants with high-risk conditions. Therapies showing favourable outcomes included Heliox, prophylactic dexamethasone pre-extubation, protein supplementation, and diuretic use.
Conclusions
Clinical trials for bronchiolitis management frequently exclude high-risk children. Innovative study design in the future may improve access to clinical trials for the management of bronchiolitis in high-risk infants in a PICU setting.
Impact
Clinical trials for bronchiolitis management frequently exclude high-risk children.
We review the evidence base for the management of an under-investigated patient demographic in the setting of acute bronchiolitis.
Randomised controlled trials are needed to determine the efficacy of management strategies for bronchiolitis in high-risk infants in a paediatric intensive care setting.</description><identifier>ISSN: 0031-3998</identifier><identifier>ISSN: 1530-0447</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/s41390-024-03340-y</identifier><identifier>PMID: 38902454</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Bronchiolitis - therapy ; Clinical trials ; Critical Care - methods ; Disease prevention ; Diuretics ; Evidence-Based Medicine ; Humans ; Infant ; Infant, Newborn ; Intensive care ; Intensive Care Units, Pediatric ; Medicine ; Medicine & Public Health ; Oxygen therapy ; Pediatric Surgery ; Pediatrics ; Respiratory distress syndrome ; Risk Factors ; Systematic Review</subject><ispartof>Pediatric research, 2024-06, Vol.96 (7), p.1560-1567</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>Copyright Nature Publishing Group Dec 2024</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-798614a20655222bb286b561ed4025768b4d4edd7807ac3b749342c5c1f2a2773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41390-024-03340-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41390-024-03340-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38902454$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Walsh, Ruth</creatorcontrib><creatorcontrib>Costello, Liam</creatorcontrib><creatorcontrib>DiCosimo, Alexandria</creatorcontrib><creatorcontrib>Doyle, Anne-Marie</creatorcontrib><creatorcontrib>Kehoe, Laura</creatorcontrib><creatorcontrib>Mulhall, Cormac</creatorcontrib><creatorcontrib>O’Hara, Sean</creatorcontrib><creatorcontrib>Elnazir, Basil</creatorcontrib><creatorcontrib>Meehan, Judith</creatorcontrib><creatorcontrib>Isweisi, Eman</creatorcontrib><creatorcontrib>Semova, Gergana</creatorcontrib><creatorcontrib>Branagan, Aoife</creatorcontrib><creatorcontrib>Roche, Edna</creatorcontrib><creatorcontrib>Molloy, Eleanor</creatorcontrib><title>Bronchiolitis: evidence-based management in high-risk infants in the intensive care setting</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><addtitle>Pediatr Res</addtitle><description>Aim
Systematically review the management of infants with severe bronchiolitis in a paediatric intensive care unit (PICU) setting with a focus on high-risk infants to identify gaps in evidence-based knowledge.
Methods
This systematic review utilised Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) to examine the literature on the PICU management of bronchiolitis in infants <24 months old. Three databases, Embase, PubMed and Medline, were searched and higher levels of evidence I, II and III were included.
Results
There were 455 papers reviewed and 26 met the inclusion criteria. Furthermore, 19 of these studied respiratory interventions such as positive airway pressure and oxygen delivery. The remaining 7 examined: erythropoietin, caffeine, dexamethasone, protein supplementation, ribavirin, respiratory syncytial virus immune globulin, or diuretic therapy. Of the 26 studies, 20 excluded infants with high-risk conditions. Therapies showing favourable outcomes included Heliox, prophylactic dexamethasone pre-extubation, protein supplementation, and diuretic use.
Conclusions
Clinical trials for bronchiolitis management frequently exclude high-risk children. Innovative study design in the future may improve access to clinical trials for the management of bronchiolitis in high-risk infants in a PICU setting.
Impact
Clinical trials for bronchiolitis management frequently exclude high-risk children.
We review the evidence base for the management of an under-investigated patient demographic in the setting of acute bronchiolitis.
Randomised controlled trials are needed to determine the efficacy of management strategies for bronchiolitis in high-risk infants in a paediatric intensive care setting.</description><subject>Bronchiolitis - therapy</subject><subject>Clinical trials</subject><subject>Critical Care - methods</subject><subject>Disease prevention</subject><subject>Diuretics</subject><subject>Evidence-Based Medicine</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Intensive care</subject><subject>Intensive Care Units, Pediatric</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oxygen therapy</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Respiratory distress syndrome</subject><subject>Risk Factors</subject><subject>Systematic Review</subject><issn>0031-3998</issn><issn>1530-0447</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9UcmO1DAQtRCIaRp-gAOKxIWLobzFDhcEIzZpJC5w4mA5TnXiIXEG291S_z0eehiWA6dSVb33anmEPGbwnIEwL7JkogMKXFIQQgI93iEbpkQtSanvkg2AYFR0nTkjD3K-BGBSGXmfnAnTVZaSG_L1TVqjn8I6hxLyywYPYcDokfYu49AsLroRF4ylCbGZwjjRFPK3muxcLPm6WCasoWDM4YCNdwmbjKWEOD4k93ZuzvjoJm7Jl3dvP59_oBef3n88f31BveRtobozLZOOQ6sU57zvuWl71TIcJHClW9PLQeIwaAPaedFr2QnJvfJsxx3XWmzJq5Pu1b5fcPB12-Rme5XC4tLRri7YvzsxTHZcD5YxretEWRWe3Sik9fsec7FLyB7n2UVc99kK0GBEp-pDt-TpP9DLdZ9ivc8K1gLnjHemovgJ5dOac8Ld7TYM7LV59mSerTbYn-bZYyU9-fOOW8ovtypAnAC5tuKI6ffs_8j-AHXppXw</recordid><startdate>20240620</startdate><enddate>20240620</enddate><creator>Walsh, Ruth</creator><creator>Costello, Liam</creator><creator>DiCosimo, Alexandria</creator><creator>Doyle, Anne-Marie</creator><creator>Kehoe, Laura</creator><creator>Mulhall, Cormac</creator><creator>O’Hara, Sean</creator><creator>Elnazir, Basil</creator><creator>Meehan, Judith</creator><creator>Isweisi, Eman</creator><creator>Semova, Gergana</creator><creator>Branagan, Aoife</creator><creator>Roche, Edna</creator><creator>Molloy, Eleanor</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240620</creationdate><title>Bronchiolitis: evidence-based management in high-risk infants in the intensive care setting</title><author>Walsh, Ruth ; Costello, Liam ; DiCosimo, Alexandria ; Doyle, Anne-Marie ; Kehoe, Laura ; Mulhall, Cormac ; O’Hara, Sean ; Elnazir, Basil ; Meehan, Judith ; Isweisi, Eman ; Semova, Gergana ; Branagan, Aoife ; Roche, Edna ; Molloy, Eleanor</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-798614a20655222bb286b561ed4025768b4d4edd7807ac3b749342c5c1f2a2773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Bronchiolitis - therapy</topic><topic>Clinical trials</topic><topic>Critical Care - methods</topic><topic>Disease prevention</topic><topic>Diuretics</topic><topic>Evidence-Based Medicine</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intensive care</topic><topic>Intensive Care Units, Pediatric</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oxygen therapy</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Respiratory distress syndrome</topic><topic>Risk Factors</topic><topic>Systematic Review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Walsh, Ruth</creatorcontrib><creatorcontrib>Costello, Liam</creatorcontrib><creatorcontrib>DiCosimo, Alexandria</creatorcontrib><creatorcontrib>Doyle, Anne-Marie</creatorcontrib><creatorcontrib>Kehoe, Laura</creatorcontrib><creatorcontrib>Mulhall, Cormac</creatorcontrib><creatorcontrib>O’Hara, Sean</creatorcontrib><creatorcontrib>Elnazir, Basil</creatorcontrib><creatorcontrib>Meehan, Judith</creatorcontrib><creatorcontrib>Isweisi, Eman</creatorcontrib><creatorcontrib>Semova, Gergana</creatorcontrib><creatorcontrib>Branagan, Aoife</creatorcontrib><creatorcontrib>Roche, Edna</creatorcontrib><creatorcontrib>Molloy, Eleanor</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Walsh, Ruth</au><au>Costello, Liam</au><au>DiCosimo, Alexandria</au><au>Doyle, Anne-Marie</au><au>Kehoe, Laura</au><au>Mulhall, Cormac</au><au>O’Hara, Sean</au><au>Elnazir, Basil</au><au>Meehan, Judith</au><au>Isweisi, Eman</au><au>Semova, Gergana</au><au>Branagan, Aoife</au><au>Roche, Edna</au><au>Molloy, Eleanor</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bronchiolitis: evidence-based management in high-risk infants in the intensive care setting</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><addtitle>Pediatr Res</addtitle><date>2024-06-20</date><risdate>2024</risdate><volume>96</volume><issue>7</issue><spage>1560</spage><epage>1567</epage><pages>1560-1567</pages><issn>0031-3998</issn><issn>1530-0447</issn><eissn>1530-0447</eissn><abstract>Aim
Systematically review the management of infants with severe bronchiolitis in a paediatric intensive care unit (PICU) setting with a focus on high-risk infants to identify gaps in evidence-based knowledge.
Methods
This systematic review utilised Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) to examine the literature on the PICU management of bronchiolitis in infants <24 months old. Three databases, Embase, PubMed and Medline, were searched and higher levels of evidence I, II and III were included.
Results
There were 455 papers reviewed and 26 met the inclusion criteria. Furthermore, 19 of these studied respiratory interventions such as positive airway pressure and oxygen delivery. The remaining 7 examined: erythropoietin, caffeine, dexamethasone, protein supplementation, ribavirin, respiratory syncytial virus immune globulin, or diuretic therapy. Of the 26 studies, 20 excluded infants with high-risk conditions. Therapies showing favourable outcomes included Heliox, prophylactic dexamethasone pre-extubation, protein supplementation, and diuretic use.
Conclusions
Clinical trials for bronchiolitis management frequently exclude high-risk children. Innovative study design in the future may improve access to clinical trials for the management of bronchiolitis in high-risk infants in a PICU setting.
Impact
Clinical trials for bronchiolitis management frequently exclude high-risk children.
We review the evidence base for the management of an under-investigated patient demographic in the setting of acute bronchiolitis.
Randomised controlled trials are needed to determine the efficacy of management strategies for bronchiolitis in high-risk infants in a paediatric intensive care setting.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>38902454</pmid><doi>10.1038/s41390-024-03340-y</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-3998 |
| ispartof | Pediatric research, 2024-06, Vol.96 (7), p.1560-1567 |
| issn | 0031-3998 1530-0447 1530-0447 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11772224 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Bronchiolitis - therapy Clinical trials Critical Care - methods Disease prevention Diuretics Evidence-Based Medicine Humans Infant Infant, Newborn Intensive care Intensive Care Units, Pediatric Medicine Medicine & Public Health Oxygen therapy Pediatric Surgery Pediatrics Respiratory distress syndrome Risk Factors Systematic Review |
| title | Bronchiolitis: evidence-based management in high-risk infants in the intensive care setting |
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