title: Medical retrieval and needs of infants with bronchiolitis: an analysis by gestational age.
abstract: OBJECTIVE
  Viral bronchiolitis is the most common lower respiratory tract infection in children less than 12 months of age. Prematurity is an independent risk factor for disease severity. Many infected infants require hospitalisation and those living in regional centres frequently require transfer to metropolitan hospitals capable of providing assisted ventilation.
  
  
  METHODS
  We reviewed infants with bronchiolitis transported by the Victorian Newborn Emergency Transport Service between January 2003 and June 2007. We compared the clinical presentation and treatment required by infants born preterm with those of their term counterparts.
  
  
  RESULTS
  Of the 192 infants transported, 92 were born preterm. Preterm infants were younger at time of transport (mean post-menstrual age 41 weeks vs. 45 weeks) and were more likely to require invasive ventilation (60% vs. 32%, P < 0.001) and to receive a fluid bolus (47% vs. 34%, P = 0.04) when compared with infants who had been born at term. Apnoea, either as a presenting symptom or in combination with respiratory distress, was more common in the preterm group (70% vs. 36%, P < 0.001).
  
  
  CONCLUSIONS
  Higher illness severity should be anticipated in ex-preterm infants who present with bronchiolitis. Preterm infants with bronchiolitis are more likely to require invasive ventilation and fluid resuscitation than term infants, suggesting the need for a lower threshold for referral and medical retrieval.
authors.affiliation: Newborn Emergency Transport Service (NETS) Victoria, Melbourne, Victoria, Australia. drpaulfleming@gmail.com
authors.forename: Paul F
authors.initials: PF
authors.lastname: Fleming
authors.forename: Susie
authors.initials: S
authors.lastname: Richards
authors.forename: Kelly
authors.initials: K
authors.lastname: Waterman
authors.forename: Peter G
authors.initials: PG
authors.lastname: Davis
authors.forename: C Omar F
authors.initials: CO
authors.lastname: Kamlin
authors.forename: Michael
authors.initials: M
authors.lastname: Stewart
authors.forename: Jenni
authors.initials: J
authors.lastname: Sokol
mesh_terms: D001049:Apnea / Q000175:diagnosis* / Q000628:therapy; D001315:Australia; D001988:Bronchiolitis / Q000175:diagnosis* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000628:therapy; D016247:Information Storage and Retrieval; D008297:Male; D012121:Respiration, Artificial; D012189:Retrospective Studies; D012307:Risk Factors; D014739:Victoria