دورية أكاديمية
أعرض في EDS

Transition to Weight-Based High-Flow Nasal Cannula Use Outside of the ICU for Bronchiolitis.

التفاصيل البيبلوغرافية
العنوان: Transition to Weight-Based High-Flow Nasal Cannula Use Outside of the ICU for Bronchiolitis.
المؤلفون: Willer RJ; Department of Pediatrics, Division of Pediatric Hospital Medicine, University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City., Brady PW; University of Cincinnati College of Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio., Tyler AN; The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus., Treasure JD; University of Cincinnati College of Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio., Coon ER; Department of Pediatrics, Division of Pediatric Hospital Medicine, University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City.
المصدر: JAMA network open [JAMA Netw Open] 2024 Mar 04; Vol. 7 (3), pp. e242722. Date of Electronic Publication: 2024 Mar 04.
نوع المنشور: Multicenter Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Bronchiolitis*/therapy , Cannula*, Child ; Humans ; Male ; Cohort Studies ; Hospitals, Pediatric ; Intensive Care Units ; Retrospective Studies ; Female ; Infant ; Child, Preschool ; Adolescent ; Infant, Newborn
مستخلص: Importance: Most children's hospitals have adopted weight-based high-flow nasal cannula (HFNC) bronchiolitis protocols for use outside of the intensive care unit (ICU) setting. Whether these protocols are achieving their goal of reducing bronchiolitis-related ICU admissions remains unknown.
Objective: To measure the association between hospital transition to weight-based non-ICU HFNC use and subsequent ICU admission.
Design, Setting, and Participants: This multicenter retrospective cohort study was conducted with a controlled interrupted time series approach and involved 18 children's hospitals that contribute data to the Pediatric Health Information Systems database. The cohort included patients aged 0 to 24 months who were hospitalized with a diagnosis of bronchiolitis between January 1, 2010, and December 31, 2021. Data were analyzed from July 2023 to January 2024.
Exposure: Hospital-level transition from ICU-only to weight-based non-ICU protocol for HFNC use. Data for the ICU-only group were obtained from a previously published survey.
Main Outcomes and Measures: Proportion of patients with bronchiolitis admitted to the ICU.
Results: A total of 86 046 patients with bronchiolitis received care from 10 hospitals in the ICU-only group (n = 47 336; 27 850 males [58.8%]; mean [SD] age, 7.6 [6.2] years) and 8 hospitals in the weight-based protocol group (n = 38 710; 22 845 males [59.0%]; mean [SD] age, 7.7 [6.3] years). Mean age and sex were similar for patients between the 2 groups. Hospitals in the ICU-only group vs the weight-based protocol group had higher proportions of Black (26.2% vs 19.8%) and non-Hispanic (81.6% vs 63.8%) patients and patients with governmental insurance (68.1% vs 65.9%). Hospital transition to a weight-based HFNC protocol was associated with a 6.1% (95% CI, 8.7%-3.4%) decrease per year in ICU admission and a 1.5% (95% CI, 2.8%-0.1%) reduction per year in noninvasive positive pressure ventilation use compared with the ICU-only group. No differences in mean length of stay or the proportion of patients who received invasive mechanical ventilation were found between groups.
Conclusions and Relevance: Results of this cohort study of hospitalized patients with bronchiolitis suggest that transition from ICU-only to weight-based non-ICU HFNC protocols is associated with reduced ICU admission rates.
References: JAMA Netw Open. 2021 Oct 1;4(10):e2129920. (PMID: 34698848)
Pediatrics. 2020 Nov;146(5):. (PMID: 33033176)
Lancet. 2017 Mar 4;389(10072):930-939. (PMID: 28161016)
Hosp Pediatr. 2018 Jul;8(7):426-429. (PMID: 29880578)
Hosp Pediatr. 2021 Oct;11(10):1102-1112. (PMID: 34493589)
Pediatrics. 2019 Dec;144(6):. (PMID: 31699829)
Eur Respir J. 2020 Jul 16;56(1):. (PMID: 32381496)
Hosp Pediatr. 2023 May 1;13(5):387-393. (PMID: 37122050)
J Pediatr (Rio J). 2017 Nov - Dec;93 Suppl 1:36-45. (PMID: 28818509)
Int J Epidemiol. 2018 Dec 1;47(6):2082-2093. (PMID: 29982445)
J Hosp Med. 2020 Jun;15(6):325-330. (PMID: 32490796)
Hosp Pediatr. 2023 May 1;13(5):e109-e113. (PMID: 37051799)
J Paediatr Child Health. 2014 May;50(5):373-8. (PMID: 24612137)
Hosp Pediatr. 2017 Apr;7(4):197-203. (PMID: 28292850)
Pediatrics. 2021 Jun;147(6):. (PMID: 33972381)
N Engl J Med. 2018 Mar 22;378(12):1121-1131. (PMID: 29562151)
Hosp Pediatr. 2023 Apr 1;13(4):e69-e75. (PMID: 36938609)
Pediatr Crit Care Med. 2017 Dec;18(12):e606-e614. (PMID: 28930813)
معلومات مُعتمدة: UM1 TR004409 United States TR NCATS NIH HHS
تواريخ الأحداث: Date Created: 20240318 Date Completed: 20240319 Latest Revision: 20240810
رمز التحديث: 20240812
مُعرف محوري في PubMed: PMC10949097
DOI: 10.1001/jamanetworkopen.2024.2722
PMID: 38497961
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2024.2722