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Clinical practice guidelines: management of severe bronchiolitis in infants under 12 months old admitted to a pediatric critical care unit

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Abstract

Purpose

We present guidelines for the management of infants under 12 months of age with severe bronchiolitis with the aim of creating a series of pragmatic recommendations for a patient subgroup that is poorly individualized in national and international guidelines.

Methods

Twenty-five French-speaking experts, all members of the Groupe Francophone de Réanimation et Urgence Pédiatriques (French‐speaking group of paediatric intensive and emergency care; GFRUP) (Algeria, Belgium, Canada, France, Switzerland), collaborated from 2021 to 2022 through teleconferences and face-to-face meetings. The guidelines cover five areas: (1) criteria for admission to a pediatric critical care unit, (2) environment and monitoring, (3) feeding and hydration, (4) ventilatory support and (5) adjuvant therapies. The questions were written in the Patient-Intervention-Comparison-Outcome (PICO) format. An extensive Anglophone and Francophone literature search indexed in the MEDLINE database via PubMed, Web of Science, Cochrane and Embase was performed using pre-established keywords. The texts were analyzed and classified according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. When this method did not apply, an expert opinion was given. Each of these recommendations was voted on by all the experts according to the Delphi methodology.

Results

This group proposes 40 recommendations. The GRADE methodology could be applied for 17 of them (3 strong, 14 conditional) and an expert opinion was given for the remaining 23. All received strong approval during the first round of voting.

Conclusion

These guidelines cover the different aspects in the management of severe bronchiolitis in infants admitted to pediatric critical care units. Compared to the different ways to manage patients with severe bronchiolitis described in the literature, our original work proposes an overall less invasive approach in terms of monitoring and treatment.

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References

  1. Mahant S, Parkin PC, Thavam T, Imsirovic H, Tuna M, Knight B et al (2022) Rates in bronchiolitis hospitalization, intensive care unit use, mortality, and costs from 2004 to 2018. JAMA Pediatr 176(3):270–279

    Article  Google Scholar 

  2. Gupta P, Beam BW, Rettiganti M (2016) Temporal trends of respiratory syncytial virus-associated hospital and ICU admissions across the United States. Pediatr Crit Care Med 17(8):e343–e351

    Article  Google Scholar 

  3. France SP (2021) Bilan de la surveillance hivernale 2020–2021

  4. Deshpande SA, Northern V (2003) The clinical and health economic burden of respiratory syncytial virus disease among children under 2 years of age in a defined geographical area. Arch Dis Child 88(12):1065–1069

    Article  CAS  Google Scholar 

  5. Hasegawa K, Tsugawa Y, Brown DF, Mansbach JM, Camargo CA Jr (2013) Trends in bronchiolitis hospitalizations in the United States, 2000–2009. Pediatrics 132(1):28–36

    Article  Google Scholar 

  6. Santé Had (2018) Prise en charge du premier épisode de bronchiolite aiguë chez le nourrisson de moins de 12 mois

  7. Ricci V, Delgado Nunes V, Murphy MS, Cunningham S, Guideline Development G, Technical T (2015) Bronchiolitis in children: summary of NICE guidance. BMJ 350:h2305

    Article  Google Scholar 

  8. O’Brien S, Borland ML, Cotterell E, Armstrong D, Babl F, Bauert P et al (2019) Australasian bronchiolitis guideline. J Paediatr Child Health 55(1):42–53

    Article  Google Scholar 

  9. Friedman JN, Rieder MJ, Walton JM, Canadian Paediatric Society ACCDT (2014) Hazardous Substances C. Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age. Paediatr Child Health 19(9):485–498

    Article  Google Scholar 

  10. Khemani RG, Smith LS, Zimmerman JJ, Erickson S, Pediatric Acute Lung Injury Consensus Conference G (2015) Pediatric acute respiratory distress syndrome: definition, incidence, and epidemiology: proceedings from the Pediatric Acute Lung Injury Consensus Conference. Pediatr Crit Care Med 16(5 Suppl 1):S23-40

    Article  Google Scholar 

  11. Kneyber MCJ, de Luca D, Calderini E, Jarreau PH, Javouhey E, Lopez-Herce J et al (2017) Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC). Intensive Care Med 43(12):1764–1780

    Article  Google Scholar 

  12. Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S et al (2004) Grading quality of evidence and strength of recommendations. BMJ 328(7454):1490

    Article  Google Scholar 

  13. Coskun Y, Saglam F, Mamal-Torun M, Akman I (2017) Risk factors for intensive care need in children with bronchiolitis: a case-control study. Turk J Pediatr 59(5):520–523

    Article  Google Scholar 

  14. Wang EE, Law BJ, Stephens D (1995) Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) prospective study of risk factors and outcomes in patients hospitalized with respiratory syncytial viral lower respiratory tract infection. J Pediatr 126(2):212–219

    Article  CAS  Google Scholar 

  15. Mansbach JM, Piedra PA, Stevenson MD, Sullivan AF, Forgey TF, Clark S et al (2012) Prospective multicenter study of children with bronchiolitis requiring mechanical ventilation. Pediatrics 130(3):e492-500

    Article  Google Scholar 

  16. Sala KA, Moore A, Desai S, Welch K, Bhandari S, Carroll CL (2015) Factors associated with disease severity in children with bronchiolitis. J Asthma 52(3):268–272

    Article  Google Scholar 

  17. Ramos-Fernandez JM, Moreno-Perez D, Gutierrez-Bedmar M, Hernandez-Yuste A, Cordon-Martinez AM, Milano-Manso G, et al (2017) [Prediction of Severe Course in Infants with RSV Bronchiolitis under 6 Months. Spain]. Rev Esp Salud Publica 91

  18. Bueno-Campana M, Sainz T, Alba M, Del Rosal T, Mendez-Echevarria A, Echevarria R et al (2019) Lung ultrasound for prediction of respiratory support in infants with acute bronchiolitis: a cohort study. Pediatr Pulmonol 54(6):873–880

    Article  Google Scholar 

  19. Cambonie G, Milesi C, Jaber S, Amsallem F, Barbotte E, Picaud JC et al (2008) Nasal continuous positive airway pressure decreases respiratory muscles overload in young infants with severe acute viral bronchiolitis. Intensive Care Med 34(10):1865–1872

    Article  Google Scholar 

  20. Milesi C, Essouri S, Pouyau R, Liet JM, Afanetti M, Portefaix A et al (2017) High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study). Intensive Care Med 43(2):209–216

    Article  Google Scholar 

  21. Milesi C, Matecki S, Jaber S, Mura T, Jacquot A, Pidoux O et al (2013) 6 cmH2O continuous positive airway pressure versus conventional oxygen therapy in severe viral bronchiolitis: a randomized trial. Pediatr Pulmonol 48(1):45–51

    Article  Google Scholar 

  22. Milesi C, Pierre AF, Deho A, Pouyau R, Liet JM, Guillot C et al (2018) A multicenter randomized controlled trial of a 3-L/kg/min versus 2-L/kg/min high-flow nasal cannula flow rate in young infants with severe viral bronchiolitis (TRAMONTANE 2). Intensive Care Med 44(11):1870–1878

    Article  CAS  Google Scholar 

  23. Mayordomo-Colunga J, Medina A, Rey C, Concha A, Los Arcos M, Menendez S (2010) Helmet-delivered continuous positive airway pressure with heliox in respiratory syncytial virus bronchiolitis. Acta Paediatr 99(2):308–311

    CAS  Google Scholar 

  24. Mayordomo-Colunga J, Medina A, Rey C, Los Arcos M, Concha A, Menendez S (2009) Success and failure predictors of non-invasive ventilation in acute bronchiolitis. An Pediatr (Barc) 70(1):34–39

    Article  CAS  Google Scholar 

  25. Essouri S, Durand P, Chevret L, Balu L, Devictor D, Fauroux B et al (2011) Optimal level of nasal continuous positive airway pressure in severe viral bronchiolitis. Intensive Care Med 37(12):2002–2007

    Article  Google Scholar 

  26. Metge P, Grimaldi C, Hassid S, Thomachot L, Loundou A, Martin C et al (2014) Comparison of a high-flow humidified nasal cannula to nasal continuous positive airway pressure in children with acute bronchiolitis: experience in a pediatric intensive care unit. Eur J Pediatr 173(7):953–958

    Article  Google Scholar 

  27. Delacroix E, Millet A, Pin I, Mortamet G (2020) Use of bilevel positive pressure ventilation in patients with bronchiolitis. Pediatr Pulmonol 55(11):3134–3138

    Article  Google Scholar 

  28. Guillot C, Le Reun C, Behal H, Labreuche J, Recher M, Duhamel A et al (2018) First-line treatment using high-flow nasal cannula for children with severe bronchiolitis: applicability and risk factors for failure. Arch Pediatr 25(3):213–218

    Article  CAS  Google Scholar 

  29. Nizarali Z, Cabral M, Silvestre C, Abadesso C, Nunes P, Loureiro H et al (2012) Noninvasive ventilation in acute respiratory failure from respiratory syncytial virus bronchiolitis. Rev Bras Ter Intensiva 24(4):375–380

    Article  Google Scholar 

  30. Clayton JA, McKee B, Slain KN, Rotta AT, Shein SL (2019) Outcomes of children with bronchiolitis treated with high-flow nasal cannula or noninvasive positive pressure ventilation. Pediatr Crit Care Med 20(2):128–135

    Article  Google Scholar 

  31. Flores-Gonzalez JC, Valladares CM, Yun Castilla C, Mayordomo-Colunga J, Quesada SP, Martin Delgado CM et al (2019) Association of fluid overload with clinical outcomes in critically Ill children with bronchiolitis: Bronquiolitis en la Unidad de Cuidados Intensivos Pediatricos (BRUCIP) Study. Pediatr Crit Care Med 20(3):e130–e136

    Article  Google Scholar 

  32. Oakley E, Chong V, Borland M, Neutze J, Phillips N, Krieser D et al (2017) Intensive care unit admissions and ventilation support in infants with bronchiolitis. Emerg Med Australas 29(4):421–428

    Article  Google Scholar 

  33. Naja Z, Fayad D, Khafaja S, Chamseddine S, Dbaibo G, Hanna-Wakim R (2019) Bronchiolitis admissions in a lebanese tertiary medical center: a 10 years’ experience. Front Pediatr 7:189

    Article  Google Scholar 

  34. Richard N, Komurian-Pradel F, Javouhey E, Perret M, Rajoharison A, Bagnaud A et al (2008) The impact of dual viral infection in infants admitted to a pediatric intensive care unit associated with severe bronchiolitis. Pediatr Infect Dis J 27(3):213–217

    Article  Google Scholar 

  35. Evans J, Marlais M, Abrahamson E (2012) Clinical predictors of nasal continuous positive airway pressure requirement in acute bronchiolitis. Pediatr Pulmonol 47(4):381–385

    Article  Google Scholar 

  36. Hervas D, Reina J, Yanez A, del Valle JM, Figuerola J, Hervas JA (2012) Epidemiology of hospitalization for acute bronchiolitis in children: differences between RSV and non-RSV bronchiolitis. Eur J Clin Microbiol Infect Dis 31(8):1975–1981

    Article  CAS  Google Scholar 

  37. Grimaldi M, Cornet B, Milou C, Gouyon JB (2002) Prospective regional study of an epidemic of respiratory syncytial virus (RSV) bronchiolitis. Arch Pediatr 9(6):572–580

    Article  CAS  Google Scholar 

  38. Mecklin M, Heikkila P, Korppi M (2017) Low age, low birthweight and congenital heart disease are risk factors for intensive care in infants with bronchiolitis. Acta Paediatr 106(12):2004–2010

    Article  Google Scholar 

  39. Ghazaly M, Nadel S (2018) Characteristics of children admitted to intensive care with acute bronchiolitis. Eur J Pediatr 177(6):913–920

    Article  Google Scholar 

  40. Shmueli E, Goldberg O, Mei-Zahav M, Stafler P, Bar-On O, Levine H et al (2021) Risk factors for respiratory syncytial virus bronchiolitis hospitalizations in children with chronic diseases. Pediatr Pulmonol 56(7):2204–2211

    Article  Google Scholar 

  41. Tsou P, Vadivelan A, Kovvuri M, Garg N, Thangavelu M, Wang Y et al (2020) Association between multiple respiratory viral infections and pediatric intensive care unit admission among infants with bronchiolitis. Arch Pediatr 27(1):39–44

    Article  CAS  Google Scholar 

  42. Bobillo-Perez S, Sorribes C, Gebelli P, Lledo N, Castilla M, Ramon M et al (2021) Lung ultrasound to predict pediatric intensive care admission in infants with bronchiolitis (LUSBRO study). Eur J Pediatr 180(7):2065–2072

    Article  Google Scholar 

  43. Supino MC, Buonsenso D, Scateni S, Scialanga B, Mesturino MA, Bock C et al (2019) Point-of-care lung ultrasound in infants with bronchiolitis in the pediatric emergency department: a prospective study. Eur J Pediatr 178(5):623–632

    Article  Google Scholar 

  44. Gori L, Amendolea A, Buonsenso D, Salvadori S, Supino MC, Musolino AM et al (2022) Prognostic role of lung ultrasound in children with bronchiolitis: multicentric prospective study. J Clin Med 11(14):4233

    Article  Google Scholar 

  45. Mongodi S, De Luca D, Colombo A, Stella A, Santangelo E, Corradi F et al (2021) Quantitative lung ultrasound: technical aspects and clinical applications. Anesthesiology 134(6):949–965

    Article  Google Scholar 

  46. Loi B, Vigo G, Baraldi E, Raimondi F, Carnielli VP, Mosca F et al (2021) Lung ultrasound to monitor extremely preterm infants and predict bronchopulmonary dysplasia. A multicenter longitudinal cohort study. Am J Respir Crit Care Med 203(11):1398–1409

    Article  CAS  Google Scholar 

  47. McCallum GB, Morris PS, Wilson CC, Versteegh LA, Ward LM, Chatfield MD et al (2013) Severity scoring systems: are they internally valid, reliable and predictive of oxygen use in children with acute bronchiolitis? Pediatr Pulmonol 48(8):797–803

    Article  Google Scholar 

  48. Luo G, Nkoy FL, Gesteland PH, Glasgow TS, Stone BL (2014) A systematic review of predictive modeling for bronchiolitis. Int J Med Inform 83(10):691–714

    Article  Google Scholar 

  49. Kadafi KT, Yuliarto S, Monica C, Susanto WP (2022) Clinical review of high flow nasal cannula and continuous positive airway pressure in pediatric acute respiratory distress. Ann Med Surg (Lond) 73:103180

    Article  Google Scholar 

  50. Beal G, Barbier C, Thoret S, Rubio A, Bonnet M, Mazet R et al (2019) Nebulized hypertonic saline 3% for 1 versus 3 days in hospitalized bronchiolitis: a blinded non-inferiority randomized controlled trial. BMC Pediatr 19(1):417

    Article  Google Scholar 

  51. Wood DW, Downes JJ, Lecks HI (1972) A clinical scoring system for the diagnosis of respiratory failure. Preliminary report on childhood status asthmaticus. Am J Dis Child 123(3):227–228

    Article  CAS  Google Scholar 

  52. Wang EE, Milner RA, Navas L, Maj H (1992) Observer agreement for respiratory signs and oximetry in infants hospitalized with lower respiratory infections. Am Rev Respir Dis 145(1):106–109

    Article  CAS  Google Scholar 

  53. Mount MC, Ji X, Kattan MW, Slain KN, Clayton JA, Rotta AT et al (2022) Derivation and Validation of the Critical Bronchiolitis Score for the PICU. Pediatr Crit Care Med 23(1):e45–e54

    Article  Google Scholar 

  54. Stollar F, Alcoba G, Gervaix A, Argiroffo CB (2014) Virologic testing in bronchiolitis: does it change management decisions and predict outcomes? Eur J Pediatr 173(11):1429–1435

    Article  Google Scholar 

  55. Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM et al (2014) Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics 134(5):e1474–e1502

    Article  Google Scholar 

  56. Hanna S, Tibby SM, Durward A, Murdoch IA (2003) Incidence of hyponatraemia and hyponatraemic seizures in severe respiratory syncytial virus bronchiolitis. Acta Paediatr 92(4):430–434

    Article  CAS  Google Scholar 

  57. Al Shibli A, Abukhater D, Al Kuwaiti N, Noureddin MB, Al Harbi M, Al Kaabi A et al (2016) Hyponatraemia and neurological complications in children admitted with bronchiolitis. Paediatr Int Child Health 36(3):175–180

    Article  Google Scholar 

  58. Shaw KN, Bell LM, Sherman NH (1991) Outpatient assessment of infants with bronchiolitis. Am J Dis Child 145(2):151–155

    CAS  Google Scholar 

  59. Ecochard-Dugelay E, Beliah M, Perreaux F, de Laveaucoupet J, Bouyer J, Epaud R et al (2014) Clinical predictors of radiographic abnormalities among infants with bronchiolitis in a paediatric emergency department. BMC Pediatr 14:143

    Article  Google Scholar 

  60. Schuh S, Lalani A, Allen U, Manson D, Babyn P, Stephens D et al (2007) Evaluation of the utility of radiography in acute bronchiolitis. J Pediatr 150(4):429–433

    Article  Google Scholar 

  61. Singh Y, Tissot C, Fraga MV, Yousef N, Cortes RG, Lopez J et al (2020) International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC). Crit Care 24(1):65

    Article  Google Scholar 

  62. Zavorsky GS, Cao J, Mayo NE, Gabbay R, Murias JM (2007) Arterial versus capillary blood gases: a meta-analysis. Respir Physiol Neurobiol 155(3):268–279

    Article  Google Scholar 

  63. Caffrey Osvald E, Clarke JR (2016) NICE clinical guideline: bronchiolitis in children. Arch Dis Child Educ Pract Ed 101(1):46–48

    Article  Google Scholar 

  64. Macias CG, Mansbach JM, Fisher ES, Riederer M, Piedra PA, Sullivan AF et al (2015) Variability in inpatient management of children hospitalized with bronchiolitis. Acad Pediatr 15(1):69–76

    Article  Google Scholar 

  65. Oakley E, Borland M, Neutze J, Acworth J, Krieser D, Dalziel S et al (2013) Nasogastric hydration versus intravenous hydration for infants with bronchiolitis: a randomised trial. Lancet Respir Med 1(2):113–120

    Article  Google Scholar 

  66. Wang L, Li X, Yang Z, Tang X, Yuan Q, Deng L et al (2016) Semi-recumbent position versus supine position for the prevention of ventilator-associated pneumonia in adults requiring mechanical ventilation. Cochrane Database Syst Rev 1:CD009946

    Google Scholar 

  67. Baudin F, Emeriaud G, Essouri S, Beck J, Portefaix A, Javouhey E et al (2019) Physiological effect of prone position in children with severe bronchiolitis: a randomized cross-over study (BRONCHIO-DV). J Pediatr 205(112–9):e4

    Google Scholar 

  68. Carande EJ, Galiza EP, Nickless A, Pollard AJ, Drysdale SB (2018) Viral bronchiolitis management in hospitals in the UK. J Clin Virol 104:29–33

    Article  Google Scholar 

  69. Cunningham S (2020) Critical care thresholds in children with bronchiolitis. Am J Perinatol 37(S 02):S42–S45

    Article  Google Scholar 

  70. Jat KR, Mathew JL (2019) Continuous positive airway pressure (CPAP) for acute bronchiolitis in children. Cochrane Database Syst Rev 1:CD010473

    Google Scholar 

  71. Vahlkvist S, Jürgensen L, la Cour A, Markoew S, Petersen TH, Kofoed PE (2020) High flow nasal cannula and continuous positive airway pressure therapy in treatment of viral bronchiolitis: a randomized clinical trial. Eur J Pediatr 179(3):513–518

    Article  CAS  Google Scholar 

  72. Shaikh N, Tripathi S, Whelan A, Ford J, Kim M, Deshpande G (2021) Association of transcutaneous CO2 with respiratory support: a prospective double blind observational study in children with bronchiolitis and reactive airway disease. J Clin Monit Comput. https://doi.org/10.1007/s10877-021-00712-1

    Article  Google Scholar 

  73. Wrotek A, Kobialka M, Jackowska T (2021) Capillary blood gas predicts risk of intensive care in children with bronchiolitis. Children (Basel) 8(8):719

    Google Scholar 

  74. Abboud PA, Roth PJ, Skiles CL, Stolfi A, Rowin ME (2012) Predictors of failure in infants with viral bronchiolitis treated with high-flow, high-humidity nasal cannula therapy*. Pediatr Crit Care Med 13(6):e343–e349

    Article  Google Scholar 

  75. Er A, Caglar A, Akgul F, Ulusoy E, Citlenbik H, Yilmaz D et al (2018) Early predictors of unresponsiveness to high-flow nasal cannula therapy in a pediatric emergency department. Pediatr Pulmonol 53(6):809–815

    Article  Google Scholar 

  76. Gal S, Riskin A, Chistyakov I, Shifman N, Srugo I, Kugelman A (2015) Transcutaneous PCO2 monitoring in infants hospitalized with viral bronchiolitis. Eur J Pediatr 174(3):319–324

    Article  CAS  Google Scholar 

  77. Srinivasan M, Pruitt C, Casey E, Dhaliwal K, DeSanto C, Markus R et al (2017) Quality improvement initiative to increase the use of nasogastric hydration in infants with bronchiolitis. Hosp Pediatr 7(8):436–443

    Article  Google Scholar 

  78. Slain KN, Martinez-Schlurmann N, Shein SL, Stormorken A (2017) Nutrition and high-flow nasal cannula respiratory support in children with bronchiolitis. Hosp Pediatr 7(5):256–262

    Article  Google Scholar 

  79. Sochet AA, McGee JA, October TW (2017) Oral nutrition in children with bronchiolitis on high-flow nasal cannula is well tolerated. Hosp Pediatr 7(5):249–255

    Article  Google Scholar 

  80. Yildirim S, Kaymaz N, Topaloglu N, Koksal Binnetoglu F, Tekin M, Aylanc H et al (2016) Do we really ponder about necessity of intravenous hydration in acute bronchiolitis? Colomb Med (Cali) 47(1):21–24

    Article  Google Scholar 

  81. Kugelman A, Raibin K, Dabbah H, Chistyakov I, Srugo I, Even L et al (2013) Intravenous fluids versus gastric-tube feeding in hospitalized infants with viral bronchiolitis: a randomized, prospective pilot study. J Pediatr 162(3):640–2 e1

    Article  Google Scholar 

  82. Oakley E, Bata S, Rengasamy S, Krieser D, Cheek J, Jachno K et al (2016) Nasogastric hydration in infants with bronchiolitis less than 2 months of age. J Pediatr 178(241–5):e1

    Google Scholar 

  83. Babl FE, Franklin D, Dalziel S, Schibler A, Paediatric Research in Emergency Departments International C, Pediatric Critical Care Research G (2020) Enteral hydration in high flow therapy. J Paediatr Child Health 56(6):989

    Article  Google Scholar 

  84. Tume LN, Eveleens RD, Mayordomo-Colunga J, Lopez J, Verbruggen S, Fricaudet M et al (2021) Enteral feeding of children on noninvasive respiratory support: a four-center european study. Pediatr Crit Care Med 22(3):e192–e202

    Article  Google Scholar 

  85. Shadman KA, Kelly MM, Edmonson MB, Sklansky DJ, Nackers K, Allen A et al (2019) Feeding during high-flow nasal cannula for bronchiolitis: associations with time to discharge. J Hosp Med 14:E43–E48

    Article  Google Scholar 

  86. Tume LN, Valla FV, Joosten K, Jotterand Chaparro C, Latten L, Marino LV et al (2020) Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations. Intensive Care Med 46(3):411–425

    Article  Google Scholar 

  87. Leroue MK, Good RJ, Skillman HE, Czaja AS (2017) Enteral nutrition practices in critically Ill children requiring noninvasive positive pressure ventilation. Pediatr Crit Care Med 18(12):1093–1098

    Article  Google Scholar 

  88. van Waardenburg DA, de Betue CT, Goudoever JB, Zimmermann LJ, Joosten KF (2009) Critically ill infants benefit from early administration of protein and energy-enriched formula: a randomized controlled trial. Clin Nutr 28(3):249–255

    Article  Google Scholar 

  89. Parlar-Chun R, Lafferty-Prather M, Gonzalez V, Pedroza C, Gourishankar A (2019) Protocol: randomised trial to compare nasoduodenal tube and nasogastric tube feeding in infants with bronchiolitis on high-flow nasal cannula; Bronchiolitis and High-flow nasal cannula with Enteral Tube feeding Randomised (BHETR) trial. BMJ Open 9(5):e025405

    Google Scholar 

  90. Valla FV, Baudin F, Demaret P, Rooze S, Moullet C, Cotting J et al (2019) Nutritional management of young infants presenting with acute bronchiolitis in Belgium, France and Switzerland: survey of current practices and documentary search of national guidelines worldwide. Eur J Pediatr 178(3):331–340

    Article  Google Scholar 

  91. de Betue CT, van Waardenburg DA, Deutz NE, van Eijk HM, van Goudoever JB, Luiking YC et al (2011) Increased protein-energy intake promotes anabolism in critically ill infants with viral bronchiolitis: a double-blind randomised controlled trial. Arch Dis Child 96(9):817–822

    Article  Google Scholar 

  92. Ng GYH, Ong C, Wong JJM, Teoh OH, Sultana R, Mok YH et al (2020) Nutritional status, intake, and outcomes in critically ill children with bronchiolitis. Pediatr Pulmonol 55(5):1199–1206

    Article  Google Scholar 

  93. Mehta NM, Bechard LJ, Zurakowski D, Duggan CP, Heyland DK (2015) Adequate enteral protein intake is inversely associated with 60-d mortality in critically ill children: a multicenter, prospective, cohort study. Am J Clin Nutr 102(1):199–206

    Article  CAS  Google Scholar 

  94. Bechard LJ, Staffa SJ, Zurakowski D, Mehta NM (2021) Time to achieve delivery of nutrition targets is associated with clinical outcomes in critically ill children. Am J Clin Nutr 114(5):1859–1867

    Article  Google Scholar 

  95. Rodrigues RM, Schvartsman BG, Farhat SC, Schvartsman C (2014) Hypotonic solution decreases serum sodium in infants with moderate bronchiolitis. Acta Paediatr 103(3):e111–e115

    Article  CAS  Google Scholar 

  96. Shein SL, Slain K, Martinez Schlurmann N, Speicher R, Rotta AT (2017) Hyponatremia and hypotonic intravenous fluids are associated with unfavorable outcomes of bronchiolitis admissions. Hosp Pediatr 7(5):263–270

    Article  Google Scholar 

  97. Feld LG, Neuspiel DR, Foster BA, Leu MG, Garber MD, Austin K et al (2018) Clinical practice guideline: maintenance intravenous fluids in children. Pediatrics. https://doi.org/10.1542/peds.2018-3083

    Article  Google Scholar 

  98. Hulst JM, Joosten KF, Tibboel D, van Goudoever JB (2006) Causes and consequences of inadequate substrate supply to pediatric ICU patients. Curr Opin Clin Nutr Metab Care 9(3):297–303

    Article  Google Scholar 

  99. Ingelse SA, Geukers VG, Dijsselhof ME, Lemson J, Bem RA, van Woensel JB (2019) Less is more? A feasibility study of fluid strategy in critically Ill children with acute respiratory tract infection. Front Pediatr 7:496

    Article  Google Scholar 

  100. Peterson RJ, Hassumani DO, Hole AJ, Slaven JE, Tori AJ, Abu-Sultaneh S (2021) Implementation of a high-flow nasal cannula management protocol in the pediatric ICU. Respir Care 66(4):591–599

    Article  Google Scholar 

  101. Noelck M, Foster A, Kelly S, Arehart A, Rufener C, Wagner T et al (2021) SCRATCH trial: an initiative to reduce excess use of high-flow nasal cannula. Hosp Pediatr 11(4):319–326

    Article  Google Scholar 

  102. Delacroix E, Millet A, Wroblewski I, Vilotitch A, Pin I, Ego A et al (2021) Has the introduction of high-flow nasal cannula modified the clinical characteristics and outcomes of infants with bronchiolitis admitted to pediatric intensive care units? A retrospective study. Arch Pediatr 28(2):141–146

    Article  CAS  Google Scholar 

  103. Pedersen MB, Vahlkvist S (2017) Comparison of CPAP and HFNC in management of bronchiolitis in infants and young children. Children (Basel) 4(4)

  104. Thia LP, McKenzie SA, Blyth TP, Minasian CC, Kozlowska WJ, Carr SB (2008) Randomised controlled trial of nasal continuous positive airways pressure (CPAP) in bronchiolitis. Arch Dis Child 93(1):45–47

    Article  Google Scholar 

  105. Milesi C, Baleine J, Matecki S, Durand S, Combes C, Novais AR et al (2013) Is treatment with a high flow nasal cannula effective in acute viral bronchiolitis? A physiologic study. Intensive Care Med 39(6):1088–1094

    Article  Google Scholar 

  106. Pham TM, O’Malley L, Mayfield S, Martin S, Schibler A (2015) The effect of high flow nasal cannula therapy on the work of breathing in infants with bronchiolitis. Pediatr Pulmonol 50(7):713–720

    Article  Google Scholar 

  107. Hough JL, Pham TM, Schibler A (2014) Physiologic effect of high-flow nasal cannula in infants with bronchiolitis. Pediatr Crit Care Med 15(5):e214–e219

    Article  Google Scholar 

  108. Weiler T, Kamerkar A, Hotz J, Ross PA, Newth CJL, Khemani RG (2017) The relationship between high flow nasal cannula flow rate and effort of breathing in children. J Pediatr 189(66–71):e3

    Google Scholar 

  109. Essouri S, Laurent M, Chevret L, Durand P, Ecochard E, Gajdos V et al (2014) Improved clinical and economic outcomes in severe bronchiolitis with pre-emptive nCPAP ventilatory strategy. Intensive Care Med 40(1):84–91

    Article  Google Scholar 

  110. Essouri S, Baudin F, Chevret L, Vincent M, Emeriaud G, Jouvet P (2017) Variability of care in infants with severe bronchiolitis: less-invasive respiratory management leads to similar outcomes. J Pediatr 188(156–62):e1

    Google Scholar 

  111. Soshnick SH, Carroll CL, Cowl AS (2019) Increased use of noninvasive ventilation associated with decreased use of invasive devices in children with bronchiolitis. Crit Care Explor 1(8):e0026

    Article  Google Scholar 

  112. Cavari Y, Sofer S, Rozovski U, Lazar I (2012) Non invasive positive pressure ventilation in infants with respiratory failure. Pediatr Pulmonol 47(10):1019–1025

    Article  Google Scholar 

  113. Wang C, Guo L, Chi C, Wang X, Guo L, Wang W et al (2015) Mechanical ventilation modes for respiratory distress syndrome in infants: a systematic review and network meta-analysis. Crit Care 19:108

    Article  Google Scholar 

  114. Cesar RG, Bispo BRP, Felix P, Modolo MCC, Souza AAF, Horigoshi NK et al (2020) High-flow nasal cannula versus continuous positive airway pressure in critical bronchiolitis: a randomized controlled pilot. J Pediatr Intensive Care 9(4):248–255

    Article  Google Scholar 

  115. Sarkar M, Sinha R, Roychowdhoury S, Mukhopadhyay S, Ghosh P, Dutta K et al (2018) Comparative study between noninvasive continuous positive airway pressure and hot humidified high-flow nasal cannulae as a mode of respiratory support in infants with acute bronchiolitis in pediatric intensive care unit of a tertiary care hospital. Indian J Crit Care Med 22(2):85–90

    Article  CAS  Google Scholar 

  116. Dafydd C, Saunders BJ, Kotecha SJ, Edwards MO (2021) Efficacy and safety of high flow nasal oxygen for children with bronchiolitis: systematic review and meta-analysis. BMJ Open Respir Res 8(1):e000844

    Article  Google Scholar 

  117. Pons-Odena M, Fuente AE, Cambra Lasaosa FJ, Matute SS, Rico AP, Modesto V (2012) Non-invasive ventilation in bronchiolitis: analysis according to a chronologic classification. J Pediatr Intensive Care 1(4):193–200

    Google Scholar 

  118. Wang BC, Pei T, Lin CB, Guo R, Elashoff D, Lin JA et al (2018) Clinical characteristics and outcomes associated with nasal intermittent mandatory ventilation in acute pediatric respiratory failure. World J Crit Care Med 7(4):46–51

    Article  Google Scholar 

  119. Mayordomo-Colunga J, Pons-Odena M, Medina A, Rey C, Milesi C, Kallio M et al (2018) Non-invasive ventilation practices in children across Europe. Pediatr Pulmonol 53(8):1107–1114

    Article  Google Scholar 

  120. Chidini G, Piastra M, Marchesi T, De Luca D, Napolitano L, Salvo I et al (2015) Continuous positive airway pressure with helmet versus mask in infants with bronchiolitis: an RCT. Pediatrics 135(4):e868–e875

    Article  Google Scholar 

  121. Mayordomo-Colunga J, Rey C, Medina A, Martinez-Camblor P, Vivanco-Allende A, Concha A (2018) Helmet versus nasal-prong CPAP in infants with acute bronchiolitis. Respir Care 63(4):455–463

    Article  Google Scholar 

  122. Maamari M, Nino G, Bost J, Cheng Y, Sochet A, Sharron M (2022) Predicting failure of non-invasive ventilation with RAM cannula in bronchiolitis. J Intensive Care Med 37(1):120–127

    Article  Google Scholar 

  123. Velasco Arnaiz E, Cambra Lasaosa FJ, Hernandez Platero L, Millan Garcia Del Real N, Pons-Odena M (2014) Is a nasopharyngeal tube effective as interface to provide bi-level noninvasive ventilation? Respir Care 59(4):510–517

    Article  Google Scholar 

  124. Franklin D, Babl FE, Schlapbach LJ, Oakley E, Craig S, Neutze J et al (2018) A randomized trial of high-flow oxygen therapy in infants with bronchiolitis. N Engl J Med 378(12):1121–1131

    Article  CAS  Google Scholar 

  125. Durand P, Guiddir T, Kyheng C, Blanc F, Vignaud O, Epaud R et al (2020) A randomised trial of high-flow nasal cannula in infants with moderate bronchiolitis. Eur Respir J 56(1):1901926

    Article  Google Scholar 

  126. Kepreotes E, Whitehead B, Attia J, Oldmeadow C, Collison A, Searles A et al (2017) High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): an open, phase 4, randomised controlled trial. Lancet 389(10072):930–939

    Article  Google Scholar 

  127. Chabernaud JL, Jourdain G, Durand S (2009) Non invasive ventilation for severe infant bronchiolitis. Arch Pediatr 16(6):726–728

    Article  Google Scholar 

  128. Lode N, Bacher M, Pinto Da Costa N, Maury I (2009) Non invasive ventilation and bronchiolitis: out-of-hospital practice. Arch Pediatr 16(6):723–725

    Article  CAS  Google Scholar 

  129. Fleming PF, Richards S, Waterman K, Davis PG, Kamlin CO, Sokol J et al (2012) Use of continuous positive airway pressure during stabilisation and retrieval of infants with suspected bronchiolitis. J Paediatr Child Health 48(12):1071–1075

    Article  Google Scholar 

  130. Schlapbach LJ, Schaefer J, Brady AM, Mayfield S, Schibler A (2014) High-flow nasal cannula (HFNC) support in interhospital transport of critically ill children. Intensive Care Med 40(4):592–599

    Article  Google Scholar 

  131. Millan N, Alejandre C, Martinez-Planas A, Caritg J, Esteban E, Pons-Odena M (2017) Noninvasive respiratory support during pediatric ground transport: implementation of a safe and feasible procedure. Respir Care 62(5):558–565

    Article  Google Scholar 

  132. Holbird S, Holt T, Shaw A, Hansen G (2020) Noninvasive ventilation for pediatric interfacility transports: a retrospective study. World J Pediatr 16(4):422–425

    Article  Google Scholar 

  133. Cheema B, Welzel T, Rossouw B (2019) Noninvasive ventilation during pediatric and neonatal critical care transport: a systematic review. Pediatr Crit Care Med 20(1):9–18

    Article  Google Scholar 

  134. Hill C, Knafl KA, Santacroce SJ (2018) Family-centered care from the perspective of parents of children cared for in a pediatric intensive care unit: an integrative review. J Pediatr Nurs 41:22–33

    Article  Google Scholar 

  135. Venkatraman R, Hungerford JL, Hall MW, Moore-Clingenpeel M, Tobias JD (2017) Dexmedetomidine for sedation during noninvasive ventilation in pediatric patients. Pediatr Crit Care Med 18(9):831–837

    Article  Google Scholar 

  136. Piastra M, Pizza A, Gaddi S, Luca E, Genovese O, Picconi E et al (2018) Dexmedetomidine is effective and safe during NIV in infants and young children with acute respiratory failure. BMC Pediatr 18(1):282

    Article  CAS  Google Scholar 

  137. Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H et al (2013) Glucocorticoids for acute viral bronchiolitis in infants and young children. Cochrane Database Syst Rev 6:CD004878

    Google Scholar 

  138. Somers CC, Ahmad N, Mejias A, Buckingham SC, Carubelli C, Katz K et al (2009) Effect of dexamethasone on respiratory syncytial virus-induced lung inflammation in children: results of a randomized, placebo controlled clinical trial. Pediatr Allergy Immunol 20(5):477–485

    Article  Google Scholar 

  139. van Woensel JB, Vyas H, Group ST (2011) Dexamethasone in children mechanically ventilated for lower respiratory tract infection caused by respiratory syncytial virus: a randomized controlled trial. Crit Care Med 39(7):1779–1783

    Article  Google Scholar 

  140. Levin DL, Garg A, Hall LJ, Slogic S, Jarvis JD, Leiter JC (2008) A prospective randomized controlled blinded study of three bronchodilators in infants with respiratory syncytial virus bronchiolitis on mechanical ventilation. Pediatr Crit Care Med 9(6):598–604

    Article  Google Scholar 

  141. Ralston S, Hartenberger C, Anaya T, Qualls C, Kelly HW (2005) Randomized, placebo-controlled trial of albuterol and epinephrine at equipotent beta-2 agonist doses in acute bronchiolitis. Pediatr Pulmonol 40(4):292–299

    Article  Google Scholar 

  142. Patel H, Platt RW, Pekeles GS, Ducharme FM (2002) A randomized, controlled trial of the effectiveness of nebulized therapy with epinephrine compared with albuterol and saline in infants hospitalized for acute viral bronchiolitis. J Pediatr 141(6):818–824

    Article  CAS  Google Scholar 

  143. Abul-Ainine A, Luyt D (2002) Short term effects of adrenaline in bronchiolitis: a randomised controlled trial. Arch Dis Child 86(4):276–279

    Article  CAS  Google Scholar 

  144. Wainwright C, Altamirano L, Cheney M, Cheney J, Barber S, Price D et al (2003) A multicenter, randomized, double-blind, controlled trial of nebulized epinephrine in infants with acute bronchiolitis. N Engl J Med 349(1):27–35

    Article  CAS  Google Scholar 

  145. Plint AC, Johnson DW, Patel H, Wiebe N, Correll R, Brant R et al (2009) Epinephrine and dexamethasone in children with bronchiolitis. N Engl J Med 360(20):2079–2089

    Article  CAS  Google Scholar 

  146. Kua KP, Lee SWH (2017) Systematic review and meta-analysis of the efficacy and safety of combined epinephrine and corticosteroid therapy for acute bronchiolitis in infants. Front Pharmacol 8:396

    Article  Google Scholar 

  147. Flores-González JC, Dominguez-Coronel MT, Matamala Morillo MA, Aragón Ramírez M, García Ortega RM, Dávila Corrales FJ et al (2016) Does nebulized epinephrine improve the efficacy of hypertonic saline solution in the treatment of hospitalized moderate acute bronchiolitis? A double blind, randomized clinical trial. Minerva Pediatr 68(2):81–88

    Google Scholar 

  148. Flores-Gonzalez JC, Matamala-Morillo MA, Rodriguez-Campoy P, Perez-Guerrero JJ, Serrano-Moyano B, Comino-Vazquez P et al (2015) Epinephrine improves the efficacy of nebulized hypertonic saline in moderate bronchiolitis: a randomised clinical trial. PLoS ONE 10(11):e0142847

    Article  Google Scholar 

  149. Turner A, Shann F, Delzoppo C, Henning R, Slater A, Beca J et al (2014) A multicentre, randomised, double-blind, placebo-controlled trial of aminophylline for bronchiolitis in infants admitted to intensive care. Crit Care Resusc 16(3):220–224

    Google Scholar 

  150. Farley R, Spurling GK, Eriksson L, Del Mar CB (2014) Antibiotics for bronchiolitis in children under two years of age. Cochrane Database Syst Rev 10:CD005189

    Google Scholar 

  151. Field CM, Connolly JH, Murtagh G, Slattery CM, Turkington EE (1966) Antibiotic treatment of epidemic bronchiolitis—a double-blind trial. Br Med J 1(5479):83–85

    Article  CAS  Google Scholar 

  152. Kabir AR, Mollah AH, Anwar KS, Rahman AK, Amin R, Rahman ME (2009) Management of bronchiolitis without antibiotics: a multicentre randomized control trial in Bangladesh. Acta Paediatr 98(10):1593–1599

    Article  CAS  Google Scholar 

  153. Kneyber MC, van Woensel JB, Uijtendaal E, Uiterwaal CS, Kimpen JL, Dutch Antibiotics in RSVTRG (2008) Azithromycin does not improve disease course in hospitalized infants with respiratory syncytial virus (RSV) lower respiratory tract disease: a randomized equivalence trial. Pediatr Pulmonol 43(2):142–149

    Article  Google Scholar 

  154. Bilavsky E, Shouval DS, Yarden-Bilavsky H, Fisch N, Ashkenazi S, Amir J (2008) A prospective study of the risk for serious bacterial infections in hospitalized febrile infants with or without bronchiolitis. Pediatr Infect Dis J 27(3):269–270

    Article  Google Scholar 

  155. Guitart C, Alejandre C, Bobillo-Perez S, Girona-Alarcon M, Sole-Ribalta A, Cambra FJ et al (2022) Risk factors and incidence of invasive bacterial infection in severe bronchiolitis: the RICOIB prospective study. BMC Pediatr 22(1):140

    Article  CAS  Google Scholar 

  156. Cebey-Lopez M, Pardo-Seco J, Gomez-Carballa A, Martinon-Torres N, Martinon-Sanchez JM, Justicia-Grande A et al (2016) Bacteremia in children hospitalized with respiratory syncytial virus infection. PLoS ONE 11(2):e0146599

    Article  Google Scholar 

  157. Thorburn K, Harigopal S, Reddy V, Taylor N, van Saene HK (2006) High incidence of pulmonary bacterial co-infection in children with severe respiratory syncytial virus (RSV) bronchiolitis. Thorax 61(7):611–615

    Article  CAS  Google Scholar 

  158. Levin D, Tribuzio M, Green-Wrzesinki T, Ames B, Radwan S, Jarvis JD et al (2010) Empiric antibiotics are justified for infants with respiratory syncytial virus lower respiratory tract infection presenting with respiratory failure: a prospective study and evidence review. Pediatr Crit Care Med 11(3):390–395

    Google Scholar 

  159. Kneyber MC, Blusse van Oud-Alblas H, van Vliet M, Uiterwaal CS, Kimpen JL, van Vught AJ (2005) Concurrent bacterial infection and prolonged mechanical ventilation in infants with respiratory syncytial virus lower respiratory tract disease. Intensive Care Med 31(5):680–685

    Article  Google Scholar 

  160. Brook I (1998) Microbial factors leading to recurrent upper respiratory tract infections. Pediatr Infect Dis J 17(8 Suppl):S62–S67

    Article  CAS  Google Scholar 

  161. Schroeder AR, Mansbach JM, Stevenson M, Macias CG, Fisher ES, Barcega B et al (2013) Apnea in children hospitalized with bronchiolitis. Pediatrics 132(5):e1194–e1201

    Article  Google Scholar 

  162. Alansari K, Toaimah FH, Khalafalla H, El Tatawy LA, Davidson BL, Ahmed W (2016) Caffeine for the treatment of apnea in bronchiolitis: a randomized trial. J Pediatr 177:204–11.e3

    Article  CAS  Google Scholar 

  163. Heuze N, Goyer I, Porcheret F, Denis M, Faucon C, Jokic M et al (2020) Caffeine treatment for bronchiolitis-related apnea in the pediatric intensive care unit. Arch Pediatr 27(1):18–23

    Article  CAS  Google Scholar 

  164. Cesar K, Iolster T, White D, Latifi S (2012) Caffeine as treatment for bronchiolitis-related apnoea. J Paediatr Child Health 48(7):619

    Article  Google Scholar 

  165. Duffett M, Liu DM, Deshpande A, Choong K (2012) Caffeine in bronchiolitis associated apnea: a retrospective cohort study. J Pediatr Intensive Care 1(2):95–98

    Google Scholar 

  166. Liet JM, Ducruet T, Gupta V, Cambonie G (2015) Heliox inhalation therapy for bronchiolitis in infants. Cochrane Database Syst Rev 9:CD006915

    Google Scholar 

  167. Seliem W, Sultan AM (2019) Does heliox administered by low-flow nasal cannula improve respiratory distress in infants with respiratory syncytial virus acute bronchiolitis? A randomized controlled trial. An Pediatr (Engl Ed) 90(1):3–9

    Article  Google Scholar 

  168. Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP (2017) Nebulised hypertonic saline solution for acute bronchiolitis in infants. Cochrane Database Syst Rev 12:CD006458

    Google Scholar 

  169. Heikkila P, Renko M, Korppi M (2018) Hypertonic saline inhalations in bronchiolitis—a cumulative meta-analysis. Pediatr Pulmonol 53(2):233–242

    Article  Google Scholar 

  170. Everard ML, Hind D, Ugonna K, Freeman J, Bradburn M, Cooper CL et al (2014) SABRE: a multicentre randomised control trial of nebulised hypertonic saline in infants hospitalised with acute bronchiolitis. Thorax 69(12):1105–1112

    Article  Google Scholar 

  171. Morikawa Y, Miura M, Furuhata MY, Morino S, Omori T, Otsuka M et al (2018) Nebulized hypertonic saline in infants hospitalized with moderately severe bronchiolitis due to RSV infection: a multicenter randomized controlled trial. Pediatr Pulmonol 53(3):358–365

    Article  Google Scholar 

  172. Stobbelaar K, Kool M, de Kruijf D, Van Hoorenbeeck K, Jorens P, De Dooy J et al (2019) Nebulised hypertonic saline in children with bronchiolitis admitted to the paediatric intensive care unit: a retrospective study. J Paediatr Child Health 55(9):1125–1132

    Article  Google Scholar 

  173. Bernard-Narbonne F, Daoud P, Castaing H, Rousset A (2003) Effectiveness of chest physiotherapy in ventilated children with acute bronchiolitis. Arch Pediatr 10(12):1043–1047

    Article  CAS  Google Scholar 

  174. Roque i Figuls M, Gine-Garriga M, Granados Rugeles C, Perrotta C, Vilaro J (2016) Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old. Cochrane Database Syst Rev 2:CD004873

    Google Scholar 

  175. Gajdos V, Katsahian S, Beydon N, Abadie V, de Pontual L, Larrar S et al (2010) Effectiveness of chest physiotherapy in infants hospitalized with acute bronchiolitis: a multicenter, randomized, controlled trial. PLoS Med 7(9):e1000345

    Article  Google Scholar 

  176. Smith DW, Frankel LR, Mathers LH, Tang AT, Ariagno RL, Prober CG (1991) A controlled trial of aerosolized ribavirin in infants receiving mechanical ventilation for severe respiratory syncytial virus infection. N Engl J Med 325(1):24–29

    Article  CAS  Google Scholar 

  177. Meert KL, Sarnaik AP, Gelmini MJ, Lieh-Lai MW (1994) Aerosolized ribavirin in mechanically ventilated children with respiratory syncytial virus lower respiratory tract disease: a prospective, double-blind, randomized trial. Crit Care Med 22(4):566–572

    Article  CAS  Google Scholar 

  178. Guerguerian AM, Gauthier M, Lebel MH, Farrell CA, Lacroix J (1999) Ribavirin in ventilated respiratory syncytial virus bronchiolitis. A randomized, placebo-controlled trial. Am J Respir Crit Care Med 160(3):829–834

    Article  CAS  Google Scholar 

  179. Enriquez A, Chu IW, Mellis C, Lin WY (2012) Nebulised deoxyribonuclease for viral bronchiolitis in children younger than 24 months. Cochrane Database Syst Rev 11:CD008395

    Google Scholar 

  180. Alansari K, Sayyed R, Davidson BL, Al Jawala S, Ghadier M (2017) IV magnesium sulfate for bronchiolitis: a randomized trial. Chest 152(1):113–119

    Article  Google Scholar 

  181. Modaresi MR, Faghihinia J, Kelishadi R, Reisi M, Mirlohi S, Pajhang F et al (2015) Nebulized magnesium sulfate in acute bronchiolitis: a randomized controlled trial. Indian J Pediatr 82(9):794–798

    Article  Google Scholar 

  182. Debbarma R, Khera D, Singh S, Toteja N, Choudhary B, Singh K (2021) Nebulized magnesium sulphate in bronchiolitis: a randomized controlled trial. Indian J Pediatr 88(11):1080–1085

    Article  Google Scholar 

  183. Kose M, Ozturk MA, Poyrazoglu H, Elmas T, Ekinci D, Tubas F et al (2014) The efficacy of nebulized salbutamol, magnesium sulfate, and salbutamol/magnesium sulfate combination in moderate bronchiolitis. Eur J Pediatr 173(9):1157–1160

    Article  CAS  Google Scholar 

  184. Tal A, Greenberg D, Av-Gay Y, Golan-Tripto I, Feinstein Y, Ben-Shimol S et al (2018) Nitric oxide inhalations in bronchiolitis: a pilot, randomized, double-blinded, controlled trial. Pediatr Pulmonol 53(1):95–102

    Article  Google Scholar 

  185. Goldbart A, Golan-Tripto I, Pillar G, Livnat-Levanon G, Efrati O, Spiegel R et al (2020) Inhaled nitric oxide therapy in acute bronchiolitis: a multicenter randomized clinical trial. Sci Rep 10(1):9605

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Pediatric Intensive Care Unit, Montpellier University Hospital, Montpellier, France

    Christophe Milési & Julien Baleine

  2. Pediatric Intensive Care Unit, Lyon Hospital Femme-Mère-Enfants, Bron, France

    Florent Baudin, Robin Pouyau, Stéphanie Reynaud & Fréderic Valla

  3. Pediatric Intensive Care Unit, Bicêtre Hospital, Assistance Publique des Hôpitaux de Paris, Kremlin-Bicêtre, France

    Philippe Durand

  4. Pediatric Intensive Care Unit, Sainte-Justine University Hospital, Montreal, Canada

    Guillaume Emeriaud

  5. Pediatric Department, Sainte-Justine University Hospital, Montreal, Canada

    Sandrine Essouri

  6. Pediatric Intensive Care Unit, La Timone University Hospital, Assistance Publique des Hôpitaux de Marseille, Marseille, France

    Sophie Beldjilali

  7. Pediatric Intensive Care Unit, Geneva University Hospital, Geneva, Switzerland

    Alice Bordessoule

  8. Pediatric Intensive Care Unit, Toulouse University Hospital, Toulouse, France

    Sophie Breinig

  9. Intensive Care Unit, Liège University Hospital, Liège, Belgium

    Pierre Demaret

  10. Pediatric Intensive Care Unit, Point-à-Pitre University Hospital, Point-à-Pitre, France

    Philippe Desprez

  11. Pediatric Intensive Care Unit, Nantes University Hospital, Nantes, France

    Bénédicte Gaillard-Leroux

  12. Pediatric Intensive Care Unit, Bordeaux University Hospital, Bordeaux, France

    Julie Guichoux

  13. Pediatric Intensive Care Unit, Strasbourg University Hospital, Strasbourg, France

    Anne-Sophie Guilbert

  14. Pediatric Intensive Care Unit, Lille University Hospital, Lille, France

    Camille Guillot & Morgan Recher

  15. Pediatric Intensive Care Unit, Trousseau Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France

    Sandrine Jean & Jérôme Rambaud

  16. Pediatric Intensive Care Unit, Robert Debré Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France

    Michael Levy

  17. Pediatric Intensive Care Unit, Reims University Hospital, Reims, France

    Odile Noizet-Yverneau

  18. Pneumology EHS Pediatric Department, Faculté de Médecine d’Oran, Canastel, Oran, Algeria

    Karim Radoui

  19. Esquirol Library Hospices Civils de Lyon, Lyon, France

    Marie-Agnes Faure

  20. Pediatric Emergency Department, Nice University Hospital, Nice, France

    Guillaume Ferraro

  21. Pediatric Intensive Care Unit, Grenoble-Alpes University Hospital, Grenoble, France

    Guillaume Mortamet

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GM reports personal fees from Aerogen, outside the submitted work. RP reports personal fees from Adene, Aerogen, Resmed and Fisher Paykel, outside the submitted work. BG-L reports personal fees from Baxter and Novartis, outside the submitted work. FV reports personal fees from Baxter and Nutricia, outside the submitted work. GE reports personal fees from Getinge, outside the submitted work.

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Milési, C., Baudin, F., Durand, P. et al. Clinical practice guidelines: management of severe bronchiolitis in infants under 12 months old admitted to a pediatric critical care unit. Intensive Care Med 49, 5–25 (2023). https://doi.org/10.1007/s00134-022-06918-4

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