Article Text
Abstract
Aim To evaluate the effectiveness of various treatment regimens for bronchiolitis in hospitalised children in three general paediatric wards in which different treatment protocols are customary.
Patients and methods Data was retrospectively collected for all hospitalised children under two years of age with clinical bronchiolitis, between October 2012 and March 2013.
Results During the study, a total of two hundred eighty six children were hospitalised with bronchiolitis in wards A, B and C. Clinical and laboratory parameters upon admission were similar among the patients in the three wards. The treatment differed between the wards, as in ward C, use of antibiotics and hypertonic saline inhalations was significantly less (p < 0.001). Admission course and outcome were also significantly different among the wards: mean number of days with measured saturation < 92% and mean length of hospital stay were lower in ward C compared to wards A and B (1.8 days vs. 2.8 and 2.9 days, p = 0.001 and 3.9 days vs. 5.0 and 4.4, p = 0.012, respectively).
Multivariate analysis showed that low saturation upon admission, higher WBC count and the use of hypertonic saline inhalations were predictive of a longer period of saturation < 92% and a longer hospital stay. Similar results were found in the subgroup of two hundred and three children with positive respiratory-syncytial-virus nasal wash.
Conclusions No proof was found as to the added effectiveness of different treatments in bronchiolitis. Furthermore, the use of hypertonic saline inhalations might be associated with a longer period of low saturation and a longer hospital stay.