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Severity of bronchiolitis in infants is associated with their parents’ tobacco habit

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Abstract

The aim of this study was to investigate the effect of tobacco smoke exposure among severely pediatric ICU patients. A prospective epidemiological observational study was conducted among children with bronchiolitis younger than 2 years of age admitted to the Pediatric Intensive Care Unit of Children’s University Hospital La Paz during the October 2017 to March 2018 outbreak. On admission, parents were asked whether they smoked. In children who required invasive mechanical ventilation, endotracheal aspirate was collected at the time of intubation. A total of 102 patients with bronchiolitis were studied. Among these, 14 (47%) of 30 infants whose parents smoked required invasive mechanical ventilation vs. 14 (19%) of 72 whose parents were nonsmokers (p = 0.007). Among patients on invasive mechanical ventilation, 10 (71%) of 14 infants with secondhand smoke exposure presented pulmonary bacterial superinfection vs. 3 (21%) of 14 in the unexposed (p = 0.012).

Conclusion: Secondhand smoke exposure is an additional high risk for pulmonary bacterial superinfection and invasive mechanical ventilation in infants with severe acute bronchiolitis

What is known:

•Environmental tobacco smoke exposure is known to be an important risk factor for childhood lower respiratory tract infections.

•Tobacco smoke makes structural changes in the respiratory tract and reduces the immune response.

What in new:

•Secondhand smoke exposure showed to be associated with the increased need and duration of invasive mechanical ventilation, and pediatric intensive care length of stay.

•Tobacco smoke exposure is an additional risk factor for the presence of bacteria in the endotracheal aspirate.

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Data availability

Data and materials are not in a public depository and are available upon request.

Abbreviations

BPI:

Bacterial pulmonary infection

ETS:

Environmental tobacco smoke

IMV:

Invasive mechanical ventilation

PICU:

Pediatric intensive care unit

SAB:

Severe acute bronchiolitis

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Authors and Affiliations

  1. Paediatric Intensive Care Unit, Children’s University Hospital La Paz, Madrid, Spain

    Diego Rodríguez-Álvarez, Cristina Rodríguez-De Tembleque, Elena Pérez-Costa & Pedro De la Oliva

  2. Microbiology Department, Children’s University Hospital La Paz, Madrid, Spain

    Emilio Cendejas-Bueno

  3. Research Unit, La Paz University Hospital, Madrid, Spain

    Jesús Díez-Sebastian

  4. Department of Paediatrics, Autonomous University of Madrid Medical School, Madrid, Spain

    Pedro De la Oliva

  5. Department of Pediatrics. Universidad Autónoma de Madrid, Head of Paediatric Intensive Care Department, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046, Madrid, Spain

    Pedro De la Oliva

Authors
  1. Diego Rodríguez-Álvarez
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  2. Cristina Rodríguez-De Tembleque
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  3. Emilio Cendejas-Bueno
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  4. Elena Pérez-Costa
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  5. Jesús Díez-Sebastian
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  6. Pedro De la Oliva
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Contributions

All authors made substantial contributions to conception and design of the study, and/or acquisition of data and/or analysis and interpretation of data; all authors participated in drafting or critically revising the manuscript for important intellectual content; all authors gave final approval of the version submitted; and all authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Conception and design: DRA, ECB, PDO. Acquisition of data: DRA, CRDT, EPC. Processing of microbiological sample: ECB. Analysis and interpretation of data: DRA, PDO, JDS. Revising of manuscript: DRA, PDO, JDS. Final approval of manuscript: all authors

Corresponding author

Correspondence to Pedro De la Oliva.

Ethics declarations

Ethics approval

The study was approved by the Independent Ethics Committee of Hospital Universitario La Paz (Reference HULP-PI-2931)

Consent to participate

Parents’ or legal guardians’ written consent was requested to participate in the study.

Consent for publication

Parents’ or legal guardians’ written consent was requested to publish the data.

Conflict of interest

The authors declare no competing interests.

Additional information

Communicated by Nicole Ritz

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Rodríguez-Álvarez, D., Rodríguez-De Tembleque, C., Cendejas-Bueno, E. et al. Severity of bronchiolitis in infants is associated with their parents’ tobacco habit. Eur J Pediatr 180, 2563–2569 (2021). https://doi.org/10.1007/s00431-021-04099-8

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  • DOI: https://doi.org/10.1007/s00431-021-04099-8

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