Central apnoeas in infants with bronchiolitis admitted to the paediatric intensive care unit.
OBJECTIVE
To further characterize apnoea(s) complicating bronchiolitis because of respiratory syncytial virus (RSV), to describe the incidence of this complication and identify possible risk factors for apnoea(s) and its development.


METHODS
The files of infants admitted to the paediatric intensive care unit (PICU) for RSV bronchiolitis during three bronchiolitis seasons (2004-2007) were reviewed for demographic, clinical and laboratory parameters. Parameters were compared between patients with and without apnoeas.


RESULTS
Seventy-nine patients met the study criteria: 43 were admitted to the PICU for central apnoeas and the remainder for respiratory distress or failure. The percentage of infants admitted for apnoea increased during the study period (28.6 to 77.1%, p = 0.004). The overall prevalence of apnoea in this population was 4.3%. Possible risk factors for apnoea(s) were younger age (1.3 vs. 4.3 months, p = 0.002), lower admission weight (3.3 vs. 5 kg, p < 0.001), lower gestational age (35.8 vs. 37.8 weeks, p = 0.01), admission from the emergency room (50% vs. 9.1%, p < 0.001) and lack of hyperthermia (p < 0.001). Respiratory acidosis was found to be a protective factor on logistic regression analysis.


CONCLUSIONS
The prevalence of apnoea in infants admitted to the PICU for RSV bronchiolitis in our centre may be increasing. Preterm, younger infants with no fever are at relatively high risk of apnoea at presentation, while older infants with fever are at lower risk.
Schiller
Ofer
O
Schneider Children's Medical Center of Israel, Petah Tiqwa, Israel. schillero@gmail.com
Levy
Itzhak
I
Pollak
Uri
U
Kadmon
Gili
G
Nahum
Elhanan
E
Schonfeld
Tommy
T
D001988:Bronchiolitis / Q000150:complications*; D006801:Humans; D015994:Incidence; D007223:Infant; D015278:Intensive Care Units, Pediatric; D012189:Retrospective Studies; D012307:Risk Factors; D020182:Sleep Apnea, Central / Q000453:epidemiology / Q000209:etiology*