Conflict of interest: None declared.
Medical retrieval and needs of infants with bronchiolitis: An analysis by gestational age
Article first published online: 11 DEC 2012
© 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 49, Issue 3, pages E227–E231, March 2013
How to Cite
Fleming, P. F., Richards, S., Waterman, K., Davis, P. G., Kamlin, C. O. F., Stewart, M. and Sokol, J. (2013), Medical retrieval and needs of infants with bronchiolitis: An analysis by gestational age. Journal of Paediatrics and Child Health, 49: E227–E231. doi: 10.1111/jpc.12025
Institution where work was undertaken: Newborn Emergency Transport Service, The Royal Women's Hospital, Parkville, Victoria.
- Issue published online: 10 MAR 2013
- Article first published online: 11 DEC 2012
- Manuscript Accepted: 24 DEC 2011
- general paediatric;
- infectious disease;
- intensive care;
Viral bronchiolitis is the most common lower respiratory tract infection in children less than 12 months of age. Prematurity is an independent risk factor for disease severity. Many infected infants require hospitalisation and those living in regional centres frequently require transfer to metropolitan hospitals capable of providing assisted ventilation.
We reviewed infants with bronchiolitis transported by the Victorian Newborn Emergency Transport Service between January 2003 and June 2007. We compared the clinical presentation and treatment required by infants born preterm with those of their term counterparts.
Of the 192 infants transported, 92 were born preterm. Preterm infants were younger at time of transport (mean post-menstrual age 41 weeks vs. 45 weeks) and were more likely to require invasive ventilation (60% vs. 32%, P < 0.001) and to receive a fluid bolus (47% vs. 34%, P = 0.04) when compared with infants who had been born at term. Apnoea, either as a presenting symptom or in combination with respiratory distress, was more common in the preterm group (70% vs. 36%, P < 0.001).
Higher illness severity should be anticipated in ex-preterm infants who present with bronchiolitis. Preterm infants with bronchiolitis are more likely to require invasive ventilation and fluid resuscitation than term infants, suggesting the need for a lower threshold for referral and medical retrieval.