Food intake during the previous 24 h as a percentage of usual intake: a marker of hypoxia in infants with bronchiolitis: an observational, prospective, multicenter study

BMC Pediatrics

Robert Cohen³  Michel Boucherat¹  Alain Wollner¹  Marc Koskas²  Annie Elbez¹  Claudie Wollner¹  Elvira Martin¹  France de La Rocque¹  François Corrard¹ 

[1] ACTIV (Association Clinique et Thérapeutique Infantile du Val de marne), 27 rue d’Inkermann, 94100, Saint Maur des fossés, France;Physiology Lung Function Department Armand-Trousseau Hospital, Paris, France;Department of Microbiology, CHI Créteil, 40 avenue de Verdun, Créteil, France

关键词: Respiratory syncytial virus;    Supracostal retractions;    Subcostal retraction;    Intercostal retraction;    Out-patient;    Infant;    Feeding;    Hypoxia;    Bronchiolitis;   

Others  :  1164286
DOI  :  10.1186/1471-2431-13-6

 received in 2012-03-25, accepted in 2013-01-08,  发布年份 2013

【 摘 要 】

Background

Hypoxia associated with bronchiolitis is not always easy to assess on clinical grounds alone. The aim of this study was to determine the value of food intake during the previous 24 hours (bottle and spoon feeding), as a percentage of usual intake (24h FI), as a marker of hypoxia, and to compare its diagnostic value with that of usual clinical signs.

Methods

In this observational, prospective, multicenter study, 18 community pediatricians, enrolled 171 infants, aged from 0 to 6 months, with bronchiolitis (rhinorrhea + dyspnea + cough + expiratory sounds). Infants with risk factors (history of prematurity, chronic heart or lung disorders), breast-fed infants, and infants having previously been treated for bronchial disorders were excluded.

The 24h FI, subcostal, intercostal, supracostal retractions, nasal flaring, respiratory rate, pauses, cyanosis, rectal temperature and respiratory syncytial virus test results were noted. The highest stable value of transcutaneous oxygen saturation (SpO2) was recorded. Hypoxia was noted if SpO2 was below 95% and verified.

Results

24h FI ≥ 50% was associated with a 96% likelihood of SpO2 ≥ 95% [95% CI, 91–99]. In univariate analysis, 24h FI < 50% had the highest odds ratio (13.8) for SpO2 < 95%, compared to other 24h FI values and other clinical signs, as well as providing one of the best compromises between specificity (90%) and sensitivity (60%) for identifying infants with hypoxia. In multivariate analysis with adjustment for age, SpO2 < 95% was related to the presence of intercostal retractions (OR = 9.1 [95% CI, 2.4-33.8%]) and 24h FI < 50% (OR = 10.9 [95% CI, 3.0-39.1%]). Hospitalization (17 infants) was strongly related to younger age, 24h FI and intercostal retractions.

Conclusion

In practice, the measure of 24 h FI may be useful in identifying hypoxia and deserves further study.

【 授权许可】

   
2013 Corrard et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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