INTRODUCTION
Bronchiolitis is a disorder commonly caused by viral lower respiratory
tract infection in infants. Signs and symptoms typically begin with
rhinitis and cough, which can progress to tachypnea, wheezing, rales,
use of accessory muscles, and/or nasal flaring1.
Respiratory syncytial virus (RSV) acute bronchiolitis (AB) is the most
common cause of infant hospitalization2,3.
The global RSV-acute lower respiratory infection (ALRI) hospitalization
estimate, reported per 1000 children per year (95% confidence interval
[CI]), was 19.19 (15.04– 24.48) among children <1 year of
age4. Globally in 2015, an estimated 33.1 million
(uncertainty range [UR] 21.6–50.3) episodes of RSV-ALRI resulted in
approximately 3.2 million (2.7–3.8) hospital admissions and 59,600
(48,000–74,500) in-hospital deaths in children younger than 5 years. In
children younger than 6 months, 1.4 million (UR 1.2–1.7) hospital
admissions, and 27,300 (UR 20,700–36,200) in-hospital deaths were due
to RSV-ALRI5. Endotracheal intubation (ETI) is
required in approximately 24% of patients admitted to the pediatric
intensive care unit (PICU)6.
There are many risk factors for RSV infection and bronchiolitis: age
younger than 6 months7, older
siblings8,9, lung disease10,11,
congenital heart disease12, born before 35 weeks’
gestation13, and exposure to second-hand
smoke14,15. However, risk factors for severe acute
bronchiolitis (SAB) in previously healthy infants are not well known.
The main objective of this study was to investigate the effect of
tobacco smoke exposure among severely PICU patients.