A look at trends in bronchiolitis over the past decade

Bronchiolitis is a common respiratory disease in children. It accounted for 18% of all hospitalizations in the United States in 2016, excluding births, for children under the age of 2. A report in Pediatrics offered an overview of changes in ICU admissions, ventilator support, length of stay and cost for patients with bronchiolitis in the United States.1

Investigators conducted a retrospective cross-sectional study of Pediatric Health Information Systems, which is an anonymous, quality-controlled online administrative data warehouse of more than 45 children’s hospitals in the United States in more than 20 states. Data represents most major metropolitan areas in the United States. Participants were included in the study if they were discharged between January 2010 and December 2019 following a hospital stay associated with a first encounter diagnosis of viral bronchiolitis and were ventilation, non-invasive ventilation, ICU admission, length of stay, and cost.

There were a total of 203,859 admissions for bronchiolitis during the study period. Of these hospitalizations, 39,442 children were admitted to the intensive care unit; 6751 received invasive mechanical ventilation; and 9983 received non-invasive ventilation. Overall, ICU admissions for bronchiolitis doubled from 11.7% in 2010 to 24.5% in 2019 (P <.001 for the trend in comparison icu admissions all children under age of pediatric health information systems increased from to over same period.>P <.001 for the trend no significant difference was observed in use of invasive mechanical ventilation to>P = 0.414 for the trend), but the use of non-invasive ventilation has increased sevenfold (1.2% in 2010 to 9.5% in 2019, P <.001 for the trend following multivariate logistic regression investigators found that year of discharge was a significant predictor icu admission ratio: ci: and non-invasive ventilation>

Investigators concluded that there was a significant increase in the proportion of children with bronchiolitis who were admitted to the intensive care unit and received non-invasive ventilation. They called for further study to understand the trends.


1. Pelletier J, Au A, Fuhrman D, Clark R, Horvat C. Trends in bronchiolitis intensive care admissions and ventilation practices: 2010-2019. Pediatrics. May 19, 2021. Electronic publication ahead of print. doi: 10.1542 / peds.2020-039115

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