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dc.contributor.authorSchlapbach, Luregn J
dc.contributor.authorStraney, Lahn
dc.contributor.authorGelbart, Ben
dc.contributor.authorAlexander, Janet
dc.contributor.authorFranklin, Donna
dc.contributor.authorBeca, John
dc.contributor.authorWhitty, Jennifer A
dc.contributor.authorGanu, Subodh
dc.contributor.authorWilkins, Barry
dc.contributor.authorSlater, Anthony
dc.contributor.authorCroston, Elizabeth
dc.contributor.authorErickson, Simon
dc.contributor.authorSchibler, Andreas
dc.date.accessioned2021-10-13T23:24:21Z
dc.date.available2021-10-13T23:24:21Z
dc.date.issued2017
dc.identifier.issn0903-1936
dc.identifier.doi10.1183/13993003.01648-2016
dc.identifier.urihttp://hdl.handle.net/10072/409022
dc.description.abstractBronchiolitis represents the most common cause of non-elective admission to paediatric intensive care units (ICUs). We assessed changes in admission rate, respiratory support, and outcomes of infants <24 months with bronchiolitis admitted to ICU between 2002 and 2014 in Australia and New Zealand. During the study period, bronchiolitis was responsible for 9628 (27.6%) of 34 829 non-elective ICU admissions. The estimated population-based ICU admission rate due to bronchiolitis increased by 11.76 per 100 000 each year (95% CI 8.11–15.41). The proportion of bronchiolitis patients requiring intubation decreased from 36.8% in 2002, to 10.8% in 2014 (adjusted OR 0.35, 95% CI 0.27–0.46), whilst a dramatic increase in high-flow nasal cannula therapy use to 72.6% was observed (p<0.001). We observed considerable variability in practice between units, with six-fold differences in risk-adjusted intubation rates that were not explained by ICU type, size, or major patient factors. Annual direct hospitalisation costs due to severe bronchiolitis increased to over USD30 million in 2014. We observed an increasing healthcare burden due to severe bronchiolitis, with a major change in practice in the management from invasive to non-invasive support that suggests thresholds to admittance of bronchiolitis patients to ICU have changed. Future studies should assess strategies for management of bronchiolitis outside ICUs.
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherEuropean Respiratory Society
dc.relation.ispartofpagefrom1601648
dc.relation.ispartofissue6
dc.relation.ispartofjournalEuropean Respiratory Journal
dc.relation.ispartofvolume49
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchcode32
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsRespiratory System
dc.subject.keywordsFLOW NASAL CANNULA
dc.subject.keywordsCLINICAL-PRACTICE GUIDELINE
dc.titleBurden of disease and change in practice in critically ill infants with bronchiolitis
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationSchlapbach, LJ; Straney, L; Gelbart, B; Alexander, J; Franklin, D; Beca, J; Whitty, JA; Ganu, S; Wilkins, B; Slater, A; Croston, E; Erickson, S; Schibler, A, Burden of disease and change in practice in critically ill infants with bronchiolitis, European Respiratory Journal, 2017, 49 (6), pp. 1601648
dcterms.dateAccepted2017-03-03
dc.date.updated2021-10-13T23:20:58Z
gro.hasfulltextNo Full Text
gro.griffith.authorWhitty, Jennifer A.


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