INTRODUCTION
Acute viral bronchiolitis (AVB) affects mainly the bronchioles, causing
mucosal inflammation, edema, and congestion in airways. Also, this
inflammation reduces the airway caliber and obstructs the airflow,
impairing breathing.1 AVB is one of the main acute
respiratory diseases affecting infants and has clinical relevance due to
the high morbidity. Moreover, the main causative agent of AVB is the
respiratory syncytial virus (RSV), and its circulation increases,
especially during autumn and winter. Infants born with less than 37
gestational weeks, low weight, heart or chronic lung disease (e.g.,
bronchopulmonary dysplasia), or immunodeficiency have a high risk of
being severely infected with RSV, requiring hospitalization in pediatric
intensive care units (PICU).2,3
RSV infection impairs lung function (especially on the fifth day),
representing a major health challenge since its treatment depends on the
severity and may progress to respiratory failure. Oxygen therapy is a
supportive measure for mild cases, while noninvasive (NIV) and invasive
mechanical ventilation (IMV) are used in moderate and severe cases
involving acute respiratory failure (ARF). These measures are combined
with salbutamol with hypertonic solution and bronchodilators, especially
in patients with respiratory distress and requiring nasogastric tube
feeding. However, the patient evolves to death if these measures are
insufficient.1,4,5
About 75% of children with bronchiolitis hospitalized in PICU require
ventilatory support, and 18% of these will need IMV because the disease
severity may lead to respiratory distress. However, technological
advances in PICU reduced the mortality related to severe
bronchiolitis.6,7 In this sense, AVB is one of the
main causes of hospitalization in PICU and may cause irreversible
impairment of airways, resulting in reduced lung function that may
remain the entire life.5,8
Intrinsic (e.g., comorbidities, disease severity at admission, and age)
and extrinsic factors (e.g., health team experience, available
resources, and clinical protocols) influences the prognosis of a child
in severe condition in PICU.9 Thus, this study aimed
to identify the epidemiological characteristics of children hospitalized
with bronchiolitis in PICU at an emergency hospital.