Continuous positive airway pressure for bronchiolitis in a general paediatric ward; a feasibility study

BMC Pediatrics

Kjersti Bårdsen¹  Knut Øymar² 

[1] Department of Paediatrics, Stavanger University Hospital, PO box 8100, 4068 Stavanger, Norway;Department of Clinical Science, University of Bergen, Bergen, Norway

关键词: Ward;    RSV;    Intensive care unit;    Infant;    CPAP;    Bronchiolitis;   

Others  :  1138862
DOI  :  10.1186/1471-2431-14-122

 received in 2013-07-15, accepted in 2014-05-05,  发布年份 2014

【 摘 要 】

Background

Continuous positive airway pressure (CPAP) is commonly used to relieve respiratory distress in infants with bronchiolitis, but has mostly been studied in an intensive care setting. Our prime aim was to evaluate the feasibility of CPAP for infants with bronchiolitis in a general paediatric ward, and secondary to assess capillary PCO₂ (cPCO₂) levels before and during treatment.

Methods

From May 1^st 2008 to April 30^th 2012, infants with bronchiolitis at Stavanger University Hospital were treated with CPAP in a general paediatric ward, but could be referred to an intensive care unit (ICU) when needed, according to in-house guidelines. Levels of cPCO₂ were prospectively registered before the start of CPAP and at approximately 4, 12, 24 and 48 hours of treatment as long as CPAP was given. We had a continuous updating program for the nurses and physicians caring for the infants with CPAP. The study was population based.

Results

672 infants (3.4%) were hospitalized with bronchiolitis. CPAP was initiated in 53 infants (0.3%; 7.9% of infants with bronchiolitis), and was well tolerated in all but three infants. 46 infants were included in the study, the majority of these (n = 33) were treated in the general ward only. These infants had lower cPCO₂ before treatment (8.0; 7.7, 8.6)(median; quartiles) than those treated at the ICU (n = 13) (9.3;8.5, 9.9) (p < 0.001). The level of cPCO₂ was significantly reduced after 4 h in both groups; 1.1 kPa (paediatric ward) (p < 0.001) and 1.3 kPa (ICU) (p = 0.002). Two infants on the ICU did not respond to CPAP (increasing cPCO₂ and severe apnoe) and were given mechanical ventilation, otherwise no side effects were observed in either group treated with CPAP.

Conclusion

Treatment with CPAP for infants with bronchiolitis may be feasible in a general paediatric ward, providing sufficient staffing and training, and the possibility of referral to an ICU when needed.

【 授权许可】

   
2014 Øymar and Bårdsen; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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