Critical care of severe bronchiolitis during shortage of ICU resources

被引：12

作者：

De Luca, Daniele ^{[1
,2
,11
]}

Pezza, Lucilla ^{[1
]}

Vivalda, Laura ^{[1
]}

Di Nardo, Matteo ^{[3
]}

Lepainteur, Margaux ^{[4
]}

Baraldi, Eugenio ^{[5
,6
]}

Piastra, Marco ^{[7
,8
]}

Ricciardi, Walter ^{[9
]}

Conti, Giorgio ^{[7
,8
]}

Gualano, Maria Rosaria ^{[10
]}

机构：

[1] Paris Saclay Univ, A Beclere Hosp, APHP, Div Paediat & Neonatal Crit Care, Paris, France

[2] Paris Saclay Univ, Physiopathol & Therapeut Innovat Unit, INSERM, U999, Paris, France

[3] Bambino Gesu Childrens Hosp IRCCS, Paediat Intens Care Unit, Rome, Italy

[4] Paris Saclay Univ, A Beclere Hosp, AP HP, Div Bacteriol Hyg, Paris, France

[5] Univ Hosp Padova, Dept Womans & Childs Hlth, Neonatal Intens Care Unit, Padua, Italy

[6] Resp Syncytial Virus NetworkRESVINET Fdn, Zeist, Netherlands

[7] A Gemelli Univ Hosp Fdn IRCCS, Paediat Intens Care Unit, Rome, Italy

[8] Univ Cattolica Sacro Cuore, Dept Biotechnol Sci Intens & Perioperat Med, Rome, Italy

[9] Univ Cattolica Sacro Cuore, Leadership Res Ctr, Rome, Italy

[10] UniCamillus St Camillus Int Univ Hlth & Med Sci, Rome, Italy

[11] Univ Paris Saclay, Hop Antoine Beclere, AP HP, Serv Pediat & Reanimat Neonatale, 157 Rue Porte Trivaux, F-92140 Clamart, France

来源：

ECLINICALMEDICINE | 2024年 / 69卷

关键词：

RSV; NICU; PICU; Respiratory failure; Outbreak; Infant; RESPIRATORY SYNCYTIAL VIRUS; POSITIVE AIRWAY PRESSURE; ADJUSTED VENTILATORY ASSIST; CLINICAL-PRACTICE GUIDELINE; INTENSIVE-CARE; DISTRESS-SYNDROME; COST-EFFECTIVENESS; LUNG ULTRASOUND; NEONATAL ARDS; INFANTS;

D O I：

10.1016/j.eclinm.2024.102450

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Large seasonal outbreaks of bronchiolitis put pressure on healthcare systems and particularly on intensive care units (ICUs). ICU admission is necessary to provide respiratory support to the severest cases, otherwise bronchiolitis can result in substantial mortality. ICU resources are often insufficient and there is scant evidence to guide the ICU clinical management. Most available studies do not cover the ICU-admitted cases and do not consider the associated public health issues. We review this topic through a multidisciplinary approach from both the clinical and public health perspectives, with an analysis based on pathophysiology and cost-effectiveness. We suggest ways to optimise respiratory care, minimise ICU stay, "protect" ICU beds and, whenever possible, make them available for other critically ill children. We also provide guidance on how to prepare ICUs to work under stressful conditions due to outbreaks and to reduce the risk of nosocomial cross-contamination, particularly in ICUs caring for high-risk children.

引用

页数：11

共 75 条

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