Mechanical Ventilation and Secondary Infections in Infants with Bronchiolitis

Abstract

Background: In this study we evaluated mechanical ventilation (MV) and Secondary bacterial infections (SBI) in infants with bronchiolitis. Methods: This is a retrospective chart review analyzing the MV course, complications and SBI in bronchiolitis infants. Descriptive statistics and unpaired t-tests were used to compare the data. Results: There were 32 infants with mean age of 2.2 ± 2.1 months, 56% were premature, 17 (53%) had Respiratory syncytial virus (RSV) and no mortality. Pressure control (PC) ventilation was used in 22 (68%) and volume control (VC) in10 (32%) patients. Initial Peak inspiratory pressures (PIP) were 26 ± 5 cm of H 2 O, Compliance was 0.4 ±0.1 ml/kg/cm of H 2 O, oxygen requirement was 67 ± 26%. Average duration of ventilation was 3.9 ±2.6 days. PIP was lower in PC compared to VC ventilation (24 ± 4 versus 28 ± 5 cm of H 2 O, with equivalent tidal volumes, p =0.04). MV duration was longer in preterm infants (5 ± 3.3 versus 2.9 ± 1.1 days, p =0.02). and in infants with poly-viral infections (5.3 ± 4.5 versus 3.4 ±1.6 days, p =0.09). Eighteen patients (56%) had SBI. These had longer MV compared to infants with no SBI (4.8 ± 3.1 versus 2.6 ±1.3 days, p =0.017). Hemophilus influenzae (31%), Moraxella catarrhalis (22%), Streptococcus pneumoniae (18%) were common organisms. Conclusion: Average duration of MV in bronchiolitis infants is 4 days with low mortality with 56% incidence of SBI. Prematurity, poly-viruses and SBI are risk factors for longer duration of MV.