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 Sep 28;9(3):185-189.
doi: 10.2478/jtim-2021-0013. eCollection 2021 Sep.

Acute Bronchiolitis: Why Put an IV Line?

Sébastien Redant  1   2 , Nora Nehar-Stern  1 , Patrick M Honoré  2 , Rachid Attou  2 , Caroline Haggenmacher  1 , Ashita Tolwani  3 , David De Bels  2 , Dominique Biarent  1
Affiliations

Acute Bronchiolitis: Why Put an IV Line?

Sébastien Redant et al. J Transl Int Med. .

Abstract

Background: Acute bronchiolitis is the most frequent cause of respiratory distress in pediatric emergency medicine. The risk of respiratory failure is frequently over evaluated, and results in systematic vascular access.

Methods: We conducted a prospective observational study in children under 18 months of age hospitalized for bronchiolitis. The aim of the study was to evaluate whether catheter insertion was useful for management. We monitored the number of catheters inserted in the emergency department and their subsequent use for rapid sequence intubation, adrenaline administration, or antimicrobial therapy. We recorded the number of secondary pediatric intensive care unit (ICU) admissions.

Results: We followed 162 patients and compared two populations, children with (population A, n = 35) and without (population B, n = 127) catheter insertion. There were no significant differences in age, oxygen saturation, heart rate, c-reactive protein, neutrophil count and the number of times nebulization was conducted at admission. Population A compared to B had a significantly higher temperature (38.1 ± 0.9 vs. 37.6 ± 0.7°C, P = 0.004) and respiratory rate (64 ±13 vs. 59 ±17, P = 0.033). Twelve patients were secondarily transferred to pediatric ICU, 3 from population A and 9 from B (NS). In a multivariate analysis, no significant relationship was found between ICU admission, venous access placement and potential confounding factors (pneumonia, age < 6 months, age < 3 months, food intake < 60%, temperature > 38° C, heart rate > 180 bpm, respiratory rate > 60/min, SpO2 < 95%, Spo2 < 90%, oxygen therapy, positive respiratory syncytial virus [RSV] sampling). Except for antimicrobial therapy (n = 32), catheters inserted in the emergency department were used in 5 patients for intravenous rehydration and in one patient in pediatric ICU for rapid sequence intubation.

Conclusions: There were no life-threatening events that required immediate venous access for cardiopulmonary resuscitation. Medical treatment could be administered orally or via nasogastric tube in most cases. Peripheral catheterization was useless in immediate emergency management and only one child required a differed rapid sequence intubation.

Keywords: bronchiolitis; catheter; hydration; resuscitation.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest Patrick M. Honore is the Co-Eidtor-in-Chief of the journal. This article was subject to the journal's standard procedures, with peer review handled independently of this editor and his research groups.

Figures

Figure 1
Figure 1
Table initial management in the emergency department (ED). EMLA: eutectic mixture of 25 mg/g lignocaine plus 25 mg/g prilocaine anesthesia.
Figure 2
Figure 2
Viral distribution of bronchiolitis
See this image and copyright information in PMC

References

    1. Diagnosis and of Management Bronchiolitis. Pediatrics. 2006;118:1774–93. American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. - PubMed
    1. Oakley F, Borland M, Neutze J, Acworth J, Krieser D, Dalziel S. Nasogastric hydration versus intrave¬nous hydration for infants with bronchiolitis: a randomized trial. The Lancet Respir Med. 2013;1:113–20. et al. - PubMed
    1. Ralston S, Lieberthal A, Meissner H, Alverson BK, Baley JE, Gadomski AM. Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics. 2014;134:e1474–502. et al. - PubMed
    1. Kugelman A, Raibin K, Dabbah H, Chistyakov I, Srugo I, Even L. Intravenous fluids versus gastric-tube feeding in hospitalized infants with viral bronchiolitis: a randomized, prospective pilot study. J Pediatr. 2013;162:640–2. et al. - PubMed
    1. Macias CG, Mansbach JM, Fisher ES, Riederer M, Piedra PA, Sullivan AF. Variability in inpatient management of children hospitalized with bronchiolitis. Acad Pediatr. 2015;15:69–76. et al. - PubMed

LinkOut - more resources