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Bronchiolitis diagnostics and treatment: Compliance with current evidence-based recommendations
Date Issued |
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2020-10-16 |
no. 1066/#1155
Poster viewing - 16-19 October
Authors whose abstracts were accepted will be published in the digital abstract book in journal Frontiers in Pediatrics
ISBN: 978-2-88966-540-2
Background. Bronchiolitis is most frequent cause of hospitalization in children <2years. Most evidence-based clinical bronchiolitis guidelines recommend minimal/ no laboratory/instrumental tests and only supportive management. Aims To evaluate treatment of children referred to pediatric emergency department (PED) with bronchiolitis and hospitalized into Pediatric Department (PD); to compare dominant diagnostic and treatment practices in our hospital. Methods. Retrospective single-center study. Data of children<2y hospitalized to PD 2018 March-2019 June were included. Exclusion:lack of medical documentation, neonatal age. Diagnostics, treatment use were evaluated. Results. 115 patients referred to PED due to bronchiolitis were later hospitalized. Only 99 (86.1%) met inclusion criteria and were analyzed. Median age–3mo (min 1mo, max 12mo);59.6% (n=59) were male. Most frequent symptoms in PED–subfebrile T°C(n=69, 69.7%), cough (n=89, 89.9%), dyspnea (n=57, 57.6%), ARDS (n=70, 70.7%). Mean SpO2–92.4±5.72%; RR–45.2±13.2bpm, auscultation findings–crackles (75.8%), wheezing (81.2%). Routine blood test performed for 29.3%(n=29) in PED and for 41.4%(n=41) in PD, eight–tested twice (in PED and PD).59 (59.6%) received chest X-ray.69 children required oxygen therapy.57.6% of patients received salbutamol in PED and 79.8%(n=79) in PD(average duration 4.7±3.5d). Glucocorticoids (GC) were administered in 20.2%(n=20) in PED vs 31.3%(n=31) in PD.11 patients were prescribed antibiotics. Mean length of stay (LOS)–4.9±3.9d. LOS was longer when children received oxygen or GC(5.67±4.4d and 7.1±5.8d respectively).
Conclusions. Despite worldwide recommendations, in our study majority of children received blood tests, lung X-rays and treatment with salbutamol, GC (LOS was longer with salbutamol and GC).