title: Review of treatment of bronchiolitis related apnoea in two centres.
abstract: OBJECTIVE
  To determine whether the use of negative pressure ventilation (NPV) was associated with a lower rate of endotracheal intubation in infants with recurrent apnoea secondary to acute bronchiolitis.
  
  
  METHODS
  Retrospective review of two paediatric intensive care units (PICU) databases and case notes; one PICU offered NPV.
  
  
  RESULTS
  Fifty two infants with bronchiolitis related apnoea were admitted to the two PICUs (31 to the NPV centre). There were no significant differences between infants in the two centres in age and weight on admission, gestational age at birth, birth weight, history of apnoea of prematurity or chronic lung disease, days ill before referral, respiratory syncytial virus status, oxygen requirement before support, and numbers retrieved from secondary care centres. Respiratory support was provided to all 31 infants in the NPV centre (23 NPV, 8 PPV), and 19/21 in the non-NPV centre (18 PPV, 1 CPAP); the NPV centre had lower rates of endotracheal intubation rates (8/31 v 18/21), shorter durations of stay (median 2 v 7 days), and less use of sedation (16/31 v 18/21). In the two years after the NPV centre discontinued use of NPV, 14/17 (82%) referred cases were intubated, with a median PICU stay of 7.5 days.
  
  
  CONCLUSIONS
  The use of NPV was associated with a reduced rate of endotracheal intubation, and shorter PICU stay. A prospective randomised controlled trial of the use of NPV in the treatment of bronchiolitis related apnoea is warranted.
authors.affiliation: Department of Paediatrics, University Hospital, Queen's Medical Centre, Nottingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Al-balkhi
authors.forename: H
authors.initials: H
authors.lastname: Klonin
authors.forename: K
authors.initials: K
authors.lastname: Marinaki
authors.forename: D P
authors.initials: DP
authors.lastname: Southall
authors.forename: D A
authors.initials: DA
authors.lastname: Thomas
authors.forename: P
authors.initials: P
authors.lastname: Jones
authors.forename: M P
authors.initials: MP
authors.lastname: Samuels
mesh_terms: D001049:Apnea / Q000209:etiology / Q000534:rehabilitation*; D001988:Bronchiolitis / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D015931:Intensive Care, Neonatal; D007902:Length of Stay; D008297:Male; D012008:Recurrence; D012121:Respiration, Artificial; D016896:Treatment Outcome; D015919:Ventilators, Negative-Pressure
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