Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;180(10):3141-3149.
doi: 10.1007/s00431-021-04079-y. Epub 2021 Apr 23.

Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

Rosalie S Linssen  1 , Reinout A Bem  2 , Berber Kapitein  2 , Katrien Oude Rengerink  3   4 , Marieke H Otten  2 , Bibiche den Hollander  2 , Louis Bont  3   5   6 , Job B M van Woensel  2 ; PICE Study Group
Collaborators, Affiliations

Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units

Rosalie S Linssen et al. Eur J Pediatr. 2021 Oct.

Abstract

Respiratory syncytial virus (RSV) bronchiolitis causes substantial morbidity and mortality in young children, but insight into the burden of RSV bronchiolitis on pediatric intensive care units (PICUs) is limited. We aimed to determine the burden of RSV bronchiolitis on the PICUs in the Netherlands. Therefore, we identified all children ≤ 24 months of age with RSV bronchiolitis between 2003 and 2016 from a nationwide PICU registry. Subsequently we manually checked their patient records for correct diagnosis and collected patient characteristics, additional clinical data, respiratory support modes, and outcome. In total, 2161 children were admitted to the PICU for RSV bronchiolitis. The annual number of admissions increased significantly during the study period (β 4.05, SE 1.27, p = 0.01), and this increase was mostly driven by increased admissions in children up to 3 months old. Concomitantly, non-invasive respiratory support significantly increased (β 7.71, SE 0.92, p < 0.01), in particular the use of high flow nasal cannula (HFNC) (β 6.69, SE 0.96, p < 0.01), whereas the use of invasive ventilation remained stable.Conclusion: The burden of severe RSV bronchiolitis on PICUs has increased in the Netherlands. Concomitantly, the use of non-invasive respiratory support, especially HFNC, has increased. What is Known: • RSV bronchiolitis is a major cause of childhood morbidity and mortality and may require pediatric intensive care unit admission. • The field of pediatric critical care for severe bronchiolitis has changed due to increased non-invasive respiratory support options. What is New: • The burden of RSV bronchiolitis for the Dutch PICUs has increased. These data inform future strategic PICU resource planning and implementation of RSV preventive strategies. • There was a significant increase in the use of high flow nasal cannula at the PICU, but the use of invasive mechanical ventilation did not decrease.

Keywords: Airway management; Bronchiolitis; Child; High flow nasal cannula; Non-invasive ventilation; Respiratory syncytial viruses; Vaccination.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of eligible, excluded, and finally included patients identified in the national PICU database (PICE)
Fig. 2
Fig. 2
Annual number of PICU admissions for confirmed RSV bronchiolitis per 100,000 children aged < 24 months among the Dutch population and annual national RSV surveillance data × 1000. Red line: PICU admissions for RSV bronchiolitis per 100,000 children; blue line: surveillance data on RSV isolations among the Dutch population. X-axis: “2003” refers to the RSV season 2003–2004, “2004” refers to the RSV season 2004–2005, etc. (surveillance data on all respiratory viruses is presented in eFig. 3)
Fig. 3
Fig. 3
Annual number of PICU admissions for RSV bronchiolitis of children ≤ 24 months old as a % of total number of PICU admissions of children ≤ 24 months old in the Netherlands
Fig. 4
Fig. 4
Age groups among the children admitted to the PICU for RSV bronchiolitis. The number of children in the different age groups are displayed per 100,000 children aged < 24 months among the Dutch population. Red line: PICU admissions for RSV bronchiolitis per 100,000 children; blue line: children aged 0–3 months old, green line: children aged 4–12 months old, grey line: children aged 13–24 months old. X-axis: “2003” refers to the RSV season 2003–2004, “2004” refers to the RSV season 2004–2005, etc.
Fig. 5
Fig. 5
Initially applied modes of respiratory support for patients admitted to a Dutch PICU for RSV bronchiolitis per 100,000 children aged < 24 months old. Red line: invasive mechanical ventilation; purple line: high flow nasal cannula; blue line: nasal continuous positive airway pressure; green line: non-invasive ventilation. X-axis: “2003” refers to the RSV season 2003–2004, “2004” refers to the RSV season 2004–2005, etc.
See this image and copyright information in PMC

References

    1. Shi T, McAllister DA, O'Brien KL, Simoes EAF, Madhi SA, Gessner BD, Polack FP, Balsells E, Acacio S, Aguayo C, Alassani I, Ali A, Antonio M, Awasthi S, Awori JO, Azziz-Baumgartner E, Baggett HC, Baillie VL, Balmaseda A, Barahona A, Basnet S, Bassat Q, Basualdo W, Bigogo G, Bont L, Breiman RF, Brooks WA, Broor S, Bruce N, Bruden D, Buchy P, Campbell S, Carosone-Link P, Chadha M, Chipeta J, Chou M, Clara W, Cohen C, de Cuellar E, Dang DA, Dash-Yandag B, Deloria-Knoll M, Dherani M, Eap T, Ebruke BE, Echavarria M, de Freitas Lázaro Emediato CC, Fasce RA, Feikin DR, Feng L, Gentile A, Gordon A, Goswami D, Goyet S, Groome M, Halasa N, Hirve S, Homaira N, Howie SRC, Jara J, Jroundi I, Kartasasmita CB, Khuri-Bulos N, Kotloff KL, Krishnan A, Libster R, Lopez O, Lucero MG, Lucion F, Lupisan SP, Marcone DN, McCracken J, Mejia M, Moisi JC, Montgomery JM, Moore DP, Moraleda C, Moyes J, Munywoki P, Mutyara K, Nicol MP, Nokes DJ, Nymadawa P, da Costa Oliveira MT, Oshitani H, Pandey N, Paranhos-Baccalà G, Phillips LN, Picot VS, Rahman M, Rakoto-Andrianarivelo M, Rasmussen ZA, Rath BA, Robinson A, Romero C, Russomando G, Salimi V, Sawatwong P, Scheltema N, Schweiger B, Scott JAG, Seidenberg P, Shen K, Singleton R, Sotomayor V, Strand TA, Sutanto A, Sylla M, Tapia MD, Thamthitiwat S, Thomas ED, Tokarz R, Turner C, Venter M, Waicharoen S, Wang J, Watthanaworawit W, Yoshida LM, Yu H, Zar HJ, Campbell H, Nair H, RSV Global Epidemiology Network Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017;390(10098):946–958. doi: 10.1016/S0140-6736(17)30938-8. - DOI - PMC - PubMed
    1. Nair H, Nokes DJ, Gessner BD, Dherani M, Madhi SA, Singleton RJ, O'Brien KL, Roca A, Wright PF, Bruce N, Chandran A, Theodoratou E, Sutanto A, Sedyaningsih ER, Ngama M, Munywoki PK, Kartasasmita C, Simões EAF, Rudan I, Weber MW, Campbell H. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet. 2010;375(9725):1545–1555. doi: 10.1016/S0140-6736(10)60206-1. - DOI - PMC - PubMed
    1. Hasegawa K, Tsugawa Y, Brown DF. Trends in bronchiolitis hospitalizations in the United States, 2000-2009. Pediatrics. 2013;132(1):28–36. doi: 10.1542/peds.2012-3877. - DOI - PMC - PubMed
    1. Schlapbach LJ, Straney L, Gelbart B, et al. Burden of disease and change in practice in critically ill infants with bronchiolitis. Eur Respir J. 2017;49(6):1601648. doi: 10.1183/13993003.01648-2016. - DOI - PubMed
    1. Fujiogi M, Goto T, Yasunaga H, et al. Trends in Bronchiolitis Hospitalizations in the United States: 2000-2016. Pediatrics. 2019;144(6):e20192614. doi: 10.1542/peds.2019-2614. - DOI - PMC - PubMed