title: [Evolution of non-invasive ventilation in acute bronchiolitis].
abstract: OBJECTIVE
  The aim of the study was to analyse the evolution, over a12-year period, of the use of non-invasive (NIV) and invasive ventilation (IV) in children admitted to a Paediatric Intensive Care Unit (PICU) due to acute bronchiolitis.
  
  
  METHODS
  A retrospective observational study was performed including all children who were admitted to the PICU requiring NIV or IV between 2001 and 2012. Demographic characteristics, ventilation assistance and clinical outcome were analysed. A comparison was made between the first six years and the last 6 years of the study.
  
  
  RESULTS
  A total of 196 children were included; 30.1% of the subjects required IV and 93.3% required NIV. The median duration of IV was 9.5 days and NIV duration was 3 days. The median PICU length of stay was 7 days, and 2% of the patients died. The use of NIV increased from 79.4% in first period to 100% in the second period (P<.0001) and IV use decreased from 46% in first period to 22.6% in the last 6 years (P<.0001). Continuous positive airway pressure and nasopharyngeal tube were the most frequently used modality and interface, although the use of bi-level non-invasive ventilation (P<.001) and of nasal cannulas significantly increased (P<.0001) in the second period, and the PICU length of stay was shorter (P=.011).
  
  
  CONCLUSIONS
  The increasing use of NIV in bronchiolitis in our PICU during the last 12 years was associated with a decrease in the use of IV and length of stay in the PICU.
authors.affiliation: Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Instituto de Investigación del Hospital General Universitario Gregorio Marañón, Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, España. Electronic address: pielvi@hotmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Toledo del Castillo
authors.affiliation: Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Instituto de Investigación del Hospital General Universitario Gregorio Marañón, Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, España.
authors.forename: S N
authors.initials: SN
authors.lastname: Fernández Lafever
authors.affiliation: Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Instituto de Investigación del Hospital General Universitario Gregorio Marañón, Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: López Sanguos
authors.affiliation: Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Instituto de Investigación del Hospital General Universitario Gregorio Marañón, Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, España.
authors.forename: L
authors.initials: L
authors.lastname: Díaz-Chirón Sánchez
authors.affiliation: Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Instituto de Investigación del Hospital General Universitario Gregorio Marañón, Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Sánchez da Silva
authors.affiliation: Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Instituto de Investigación del Hospital General Universitario Gregorio Marañón, Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: López-Herce Cid
mesh_terms: D000208:Acute Disease; D001988:Bronchiolitis / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D063087:Noninvasive Ventilation / Q000706:statistics & numerical data / Q000639:trends*; D012121:Respiration, Artificial / Q000706:statistics & numerical data / Q000639:trends; D012189:Retrospective Studies; D013997:Time Factors
keywords: Bronchiolitis; Bronquiolitis; Children; Continuous positive airway pressure; Invasive ventilation; Niños; Non-invasive ventilation; Presión positiva continua en la vía aérea; Ventilación mecánica; Ventilación mecánica no invasiva