e2 44 Wang EE, Law BJ, Boucher FD, et al Pediatric Investigators Col laborative Network on Infections in Canada (PICNIC) study of admission and management variation in patients hospitalized with respi[.]
e2 44 Wang EE, Law BJ, Boucher FD, et al Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of admission and management variation in patients hospitalized with respiratory syncytial viral lower respiratory tract infection J Pediatr 1996;129(3):390-395 45 Wu S, Baker C, Lang ME, et al Nebulized hypertonic saline for bronchiolitis: a randomized clinical trial JAMA Pediatr 2014;168(7): 657-663 46 Florin TA, Shaw KN, Kittick M, Yakscoe S, Zorc JJ Nebulized hypertonic saline for bronchiolitis in the emergency department: a randomized clinical trial JAMA Pediatr 2014;168(7):664-670 47 Angoulvant F, Bellêttre X, Milcent K, et al Effect of nebulized hypertonic saline treatment in emergency departments on the hospitalization rate for acute bronchiolitis: a randomized clinical trial JAMA Pediatr 2017;171(8):e171333 48 Er A, Çağlar A, Akgül F, et al Early predictors of unresponsiveness to high-flow nasal cannula therapy in a pediatric emergency department Pediatr Pulmonol 2018;53(6):809-815 49 Fernandes RM, Plint AC, Terwee CB, et al Validity of bronchiolitis outcome measures Pediatrics 2015;135(6):e1399-e1408 50 Destino L, Weisgerber MC, Soung P, et al Validity of respiratory scores in bronchiolitis Hosp Pediatr 2012;2(4):202-209 51 Freire G, Kuppermann N, Zemek R, et al Predicting escalated care in infants with bronchiolitis Pediatrics 2018;142(3):e20174253 52 Roosevelt, G., et al., Dexamethasone in bronchiolitis: a randomised controlled trial Lancet, 1996 348(9023): p 292-5 53 Swingler GH, Hussey GD, Zwarenstein M Randomised controlled trial of clinical outcome after chest radiograph in ambulatory acute lower-respiratory infection in children Lancet 1998;351(9100):404-408 54 Florin TA, Byczkowski T, Ruddy RM, Zorc JJ, Test M, Shah SS Variation in the management of infants hospitalized for bronchiolitis persists after the 2006 American Academy of Pediatrics bronchiolitis guidelines J Pediatr 2014;165(4):786-792.e1 55 Purcell K, Fergie J Lack of usefulness of an abnormal white blood cell count for predicting a concurrent serious bacterial infection in infants and young children hospitalized with respiratory syncytial virus lower respiratory tract infection Pediatr Infect Dis J 2007; 26(4):311-315 56 Freedman SB, Haladyn JK, Floh A, Kirsh JA, Taylor G, ThullFreedman J Pediatric myocarditis: emergency department clinical findings and diagnostic evaluation Pediatrics 2007;120(6):1278-1285 57 Durani Y, Egan M, Baffa J, Selbst SM, Nager AL Pediatric myocarditis: presenting clinical characteristics Am J Emerg Med 2009; 27(8):942-947 58 Ralston S, Hill V, Waters A Occult serious bacterial infection in infants younger than 60 to 90 days with bronchiolitis: a systematic review Arch Pediatr Adolesc Med 2011;165(10):951-956 59 Shein SL, Slain K, Martinez Schlurmann N, Speicher R, Rotta AT Hyponatremia and hypotonic intravenous fluids are associated with unfavorable outcomes of bronchiolitis admissions Hosp Pediatr 2017;7(5):263-270 60 Milani GP, Rocchi A, Teatini T, et al Hyponatremia in infants with new onset moderate-severe bronchiolitis: a cross-sectional study Respir Med 2017;133:48-50 61 Hasegawa K, Stevenson MD, Mansbach JM, et al Association between hyponatremia and higher bronchiolitis severity among children in the ICU with bronchiolitis Hosp Pediatr 2015;5(7):385-389 62 Luu R, DeWitt PE, Reiter PD, et al Hyponatremia in children with bronchiolitis admitted to the pediatric intensive care unit is associated with worse outcomes J Pediatr 2013;163(6):1652-1656.e1 63 Jacobs SE, Lamson DM, St George K, Walsh TJ Human rhinoviruses Clin Microbiol Rev 2013;26(1):135-162 64 Hall CB Respiratory syncytial virus: its transmission in the hospital environment Yale J Biol Med 1982;55(3-4):219-223 65 Spaeder MC, Fackler JC Hospital-acquired viral infection increases mortality in children with severe viral respiratory infection Pediatr Crit Care Med 2011;12(6):e317-e321 66 Agah R, Cherry JD, Garakian AJ, Chapin M Respiratory syncytial virus (RSV) infection rate in personnel caring for children with RSV infections Routine isolation procedure vs routine procedure supplemented by use of masks and goggles Am J Dis Child 1987;141(6): 695-697 67 Leclair JM, Freeman J, Sullivan BF, Crowley CM, Goldmann DA Prevention of nosocomial respiratory syncytial virus infections through compliance with glove and gown isolation precautions N Engl J Med 1987;317(6):329-334 68 Andabaka T, Nickerson JW, Rojas-Reyes MX, Rueda JD, Bacic Vrca V, Barsic B Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children Cochrane Database Syst Rev 2013;(4):CD006602 69 American Academy of Pediatrics Committee on Infectious Diseases, American Academy of Pediatrics Bronchiolitis Guidelines Committee Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection Pediatrics 2014;134(2):415-420 70 Alansari K, Toaimah FH, Almatar DH, et al Monoclonal antibody treatment of RSV bronchiolitis in young infants: a randomized trial Pediatrics 2019;143(3):e20182308 71 Zhu Q, McLellan JS, Kallewaard NL, et al A highly potent extended half-life antibody as a potential RSV vaccine surrogate for all infants Sci Transl Med 2017;9(388):eaaj1928 72 Bronchiolitis: Diagnosis and Management of Bronchiolitis in Children London: National Collaborating Centre for Women’s and Children’s Health; 2015 73 O’Brien S, Borland ML, Cotterell E, et al Australasian bronchiolitis guideline J Paediatr Child Health 2019;55(1):42-53 74 Friedman JN, Rieder MJ, Walton JM Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age Paediatr Child Health 2014;19(9):485-498 75 Pierce HC, Mansbach JM, Fisher ES, et al Variability of intensive care management for children with bronchiolitis Hosp Pediatr 2015;5(4):175-184 76 Kneyber MCJ Life-threatening RSV infections in children In: Resch B, ed Human Respiratory Syncytial Virus Infection IntechOpen; 2011 77 Korppi M, Mecklin M, Heikkila P Review shows substantial variations in the use of medication for infant bronchiolitis between and within countries Acta Paediatr 2019;108(6):1016-1022 78 Oakley E, Chong V, Borland M, et al Intensive care unit admissions and ventilation support in infants with bronchiolitis Emerg Med Australas 2017;29(4):421-428 79 Essouri S, Baudin F, Chevret L, Vincent M, Emeriaud G, Jouvet P Variability of care in infants with severe bronchiolitis: less-invasive respiratory management leads to similar outcomes J Pediatr 2017;188:156-162.e1 80 Willson DF, Horn SD, Hendley JO, Smout R, Gassaway J Effect of practice variation on resource utilization in infants hospitalized for viral lower respiratory illness Pediatrics 2001;108(4):851-855 81 Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP Nebulised hypertonic saline solution for acute bronchiolitis in infants Cochrane Database Syst Rev 2017;12:CD006458 82 Bradshaw ML, Déragon A, Puligandla P, Emeriaud G, Canakis AM, Fontela PS Treatment of severe bronchiolitis: a survey of Canadian pediatric intensivists Pediatr Pulmonol 2018;53(5):613-618 83 Flores-Gonzalez JC, Mayordomo-Colunga J, Jordan I, et al Prospective multicentre study on the epidemiology and current therapeutic management of severe bronchiolitis in Spain Biomed Res Int 2017; 2017:2565397 84 Heikkila P, Renko M, Korppi M Hypertonic saline inhalations in bronchiolitis-A cumulative meta-analysis Pediatr Pulmonol 2018;53(2): 233-242 85 Stobbelaar K, Kool M, de Kruijf D, et al Nebulised hypertonic saline in children with bronchiolitis admitted to the paediatric intensive care unit: a retrospective study J Paediatr Child Health 2019;55(9):1125-1132 86 Malhotra A, Krilov LR Viral croup Pediatr Rev 2001;22(1):5-12 87 Hartling L, Bialy LM, Vandermeer B, et al Epinephrine for bronchiolitis Cochrane Database Syst Rev 2011;(6):CD003123 e3 88 Skjerven, H.O., et al., Racemic adrenaline and inhalation strategies in acute bronchiolitis N Engl J Med, 2013 368(24): p 2286-93 89 Numa AH, Williams GD, Dakin CJ The effect of nebulized epinephrine on respiratory mechanics and gas exchange in bronchiolitis Am J Respir Crit Care Med 2001;164(1):86-91 90 Levin DL, Garg A, Hall LJ, Slogic S, Jarvis JD, Leiter JC A prospective randomized controlled blinded study of three bronchodilators in infants with respiratory syncytial virus bronchiolitis on mechanical ventilation Pediatr Crit Care Med 2008;9(6):598-604 91 Carroll CL, Sala K, Zucker AR, Schramm CM Pulmonary mechanics following albuterol therapy in mechanically ventilated infants with bronchiolitis J Asthma 2012;49(7):688-696 92 Gadomski AM, Scribani MB Bronchodilators for bronchiolitis Cochrane Database Syst Rev 2014;(6):CD001266 93 Oakley E, Brys T, Borland M, et al Medication use in infants admitted with bronchiolitis Emerg Med Australas 2018;30(3):389-397 94 Fernandes RM, Hartling L Glucocorticoids for acute viral bronchiolitis in infants and young children JAMA 2014;311(1):87-88 95 Shein SL, Rotta AT, Speicher R, Slain KN, Gaston B Corticosteroid therapy during acute bronchiolitis in patients who later develop asthma Hosp Pediatr 2017;7(7):403-409 96 van Woensel JB, Wolfs TF, van Aalderen WM, et al Randomised double blind placebo controlled trial of prednisolone in children admitted to hospital with respiratory syncytial virus bronchiolitis Thorax 1997;52(7):634-637 97 van Woensel JB, Vyas H, STAR Trial Group Dexamethasone in children mechanically ventilated for lower respiratory tract infection caused by respiratory syncytial virus: a randomized controlled trial Crit Care Med 2011;39(7):1779-1783 98 van Woensel JB, van Aalderen WM, de Weerd W, et al Dexamethasone for treatment of patients mechanically ventilated for lower respiratory tract infection caused by respiratory syncytial virus Thorax 2003;58(5):383-387 99 Buckingham SC, Jafri HS, Bush AJ, et al A randomized, doubleblind, placebo-controlled trial of dexamethasone in severe respiratory syncytial virus (RSV) infection: effects on RSV quantity and clinical outcome J Infect Dis 2002;185(9):1222-1228 100 Khoshoo V, Edell D Previously healthy infants may have increased risk of aspiration during respiratory syncytial viral bronchiolitis Pediatrics 1999;104(6):1389-1390 101 Feld LG, Neuspiel DR, Foster BA, et al Clinical practice guideline: maintenance intravenous fluids in children Pediatrics 2018;142(6): e20183083 102 Flores-González JC, Valladares CM, Yun Castilla C, et al 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 2019; 20(3):e130-e136 103 Oakley E, Borland M, Neutze J, et al Nasogastric hydration versus intravenous hydration for infants with bronchiolitis: a randomised trial Lancet Respir Med 2013;1(2):113-120 104 Slain KN, Martinez-Schlurmann N, Shein SL, Stormorken A Nutrition and high-flow nasal cannula respiratory support in children with bronchiolitis Hosp Pediatr 2017;7(5):256-262 105 Leroue MK, Good RJ, Skillman HE, Czaja AS Enteral nutrition practices in critically ill children requiring noninvasive positive pressure ventilation Pediatr Crit Care Med 2017;18(12):1093-1098 106 Kerr MH, Paton JY Surfactant protein levels in severe respiratory syncytial virus infection Am J Respir Crit Care Med 1999;159(4 Pt 1): 1115-1118 107 Davison C, Ventre KM, Luchetti M, Randolph AG Efficacy of interventions for bronchiolitis in critically ill infants: a systematic review and meta-analysis Pediatr Crit Care Med 2004;5(5):482-489 108 Jat KR, Chawla D Surfactant therapy for bronchiolitis in critically ill infants Cochrane Database Syst Rev 2015(8):CD009194 109 Luchetti M, Ferrero F, Gallini C, et al Multicenter, randomized, controlled study of porcine surfactant in severe respiratory syncytial virus-induced respiratory failure Pediatr Crit Care Med 2002; 3(3):261-268 110 Luchetti M, Casiraghi G, Valsecchi R, Galassini E, Marraro G Porcine-derived surfactant treatment of severe bronchiolitis Acta Anaesthesiol Scand 1998;42(7):805-810 111 Thomas NJ, Guardia CG, Moya FR, et al A pilot, randomized, controlled clinical trial of lucinactant, a peptide-containing synthetic surfactant, in infants with acute hypoxemic respiratory failure Pediatr Crit Care Med 2012;13(6):646-653 112 Wolfler A, Piastra M, Amigoni A, et al A shared protocol for porcine surfactant use in pediatric acute respiratory distress syndrome: a feasibility study BMC Pediatr 2019;19(1):203 113 Ventre K, Randolph AG Ribavirin for respiratory syncytial virus infection of the lower respiratory tract in infants and young children Cochrane Database Syst Rev 2007(1):CD000181 114 Randolph AG, Reder L, Englund JA Risk of bacterial infection in previously healthy respiratory syncytial virus-infected young children admitted to the intensive care unit Pediatr Infect Dis J 2004;23(11):990-994 115 Thorburn K, Harigopal S, Reddy V, Taylor N, van Saene HK High incidence of pulmonary bacterial co-infection in children with severe respiratory syncytial virus (RSV) bronchiolitis Thorax 2006;61(7):611-615 116 Shein SL, Kong M, McKee B, O’Riordan M, Toltzis P, Randolph AG Antibiotic prescription in young children with respiratory syncytial virus-associated respiratory failure and associated outcomes Pediatr Crit Care Med 2019;20(2):101-109 117 Alansari K, Toaimah FH, Khalafalla H, El Tatawy LA, Davidson BL, Ahmed W Caffeine for the treatment of apnea in bronchiolitis: a randomized trial J Pediatr 2016;177:204-211.e3 118 Slain KN, Shein SL, Rotta AT The use of high-flow nasal cannula in the pediatric emergency department J Pediatr (Rio J) 2017; 93(suppl 1):36-45 119 Numa AH, Newth CJ Anatomic dead space in infants and children J Appl Physiol (1985) 1996;80(5):1485-1489 120 Arora B, Mahajan P, Zidan MA, Sethuraman U Nasopharyngeal airway pressures in bronchiolitis patients treated with high-flow nasal cannula oxygen therapy Pediatr Emerg Care 2012;28(11):1179-1184 121 Milesi C, Boubal M, Jacquot A, et al High-flow nasal cannula: recommendations for daily practice in pediatrics Ann Intensive Care 2014;4:29 122 Rubin S, Ghuman A, Deakers T, Khemani R, Ross P, Newth CJ Effort of breathing in children receiving high-flow nasal cannula Pediatr Crit Care Med 2014;15(1):1-6 123 Nielsen KR, Ellington LE, Gray AJ, Stanberry LI, Smith LS, DiBlasi RM Effect of high-flow nasal cannula on expiratory pressure and ventilation in infant, pediatric, and adult models Respir Care 2018;63(2):147-157 124 Pham TM, O’Malley L, Mayfield S, Martin S, Schibler A The effect of high flow nasal cannula therapy on the work of breathing in infants with bronchiolitis Pediatr Pulmonol 2015;50(7):713-720 125 Milesi C, Baleine J, Matecki S, et al Is treatment with a high flow nasal cannula effective in acute viral bronchiolitis? A physiologic study Intensive Care Med 2013;39(6):1088-1094 126 Weiler T, Kamerkar A, Hotz J, Ross PA, Newth CJL, Khemani RG The relationship between high flow nasal cannula flow rate and effort of breathing in children J Pediatr 2017;189:66-71.e3 127 McKiernan C, Chua LC, Visintainer PF, Allen H High flow nasal cannulae therapy in infants with bronchiolitis J Pediatr 2010; 156(4):634-638 128 Schibler A, Pham TM, Dunster KR, et al Reduced intubation rates for infants after introduction of high-flow nasal prong oxygen delivery Intensive Care Med 2011;37(5):847-852 129 Clayton JA, McKee B, Slain KN, Rotta AT, Shein SL Outcomes of children with bronchiolitis treated with high-flow nasal cannula or noninvasive positive pressure ventilation Pediatr Crit Care Med 2019;20(2):128-135 130 Kepreotes E, Whitehead B, Attia J, et al 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, 2017;389(10072):930-939 e4 131 Franklin D, Babl FE, Schlapbach LJ, et al A Randomized trial of high-flow oxygen therapy in infants with bronchiolitis N Engl J Med 2018;378(12):1121-1131 132 Ergul AB, Calıkan E, Samsa H, et al Using a high-flow nasal cannula provides superior results to OxyMask delivery in moderate to severe bronchiolitis: a randomized controlled study Eur J Pediatr 2018;177(8):1299-1307 133 Yurtseven A, Turan C, Erseven E, Saz EU Comparison of heated humidified high-flow nasal cannula flow rates (1-L.kg.min(-1) vs 2-L.kg.min (-1) ) in the management of acute bronchiolitis Pediatr Pulmonol 2019;54(6):894-900 134 Milesi C, Pierre AF, Deho A, et al 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 2018;44(11):1870-1878 135 Jat KR, Mathew JL Continuous positive airway pressure (CPAP) for acute bronchiolitis in children Cochrane Database Syst Rev 2019;1:CD010473 136 Thia LP, McKenzie SA, Blyth TP, Minasian CC, Kozlowska WJ, Carr SB Randomised controlled trial of nasal continuous positive airways pressure (CPAP) in bronchiolitis Arch Dis Child 2008; 93(1):45-47 137 Lal SN, Kaur J, Anthwal P, Goyal K, Bahl P, Puliyel JM Nasal continuous positive airway pressure in bronchiolitis: a randomized controlled trial Indian Pediatr 2018;55(1):27-30 138 Milesi C, Matecki S, Jaber S, et al cmH2O continuous positive airway pressure versus conventional oxygen therapy in severe viral bronchiolitis: a randomized trial Pediatr Pulmonol 2013;48(1):45-51 139 Piastra M, Pizza A, Gaddi S, et al Dexmedetomidine is effective and safe during NIV in infants and young children with acute respiratory failure BMC Pediatr 2018;18(1):282 140 Javouhey E, Barats A, Richard N, Stamm D, Floret D Non-invasive ventilation as primary ventilatory support for infants with severe bronchiolitis Intensive Care Med 2008;34(9):1608-1614 141 Ganu SS, Gautam A, Wilkins B, Egan J Increase in use of noninvasive ventilation for infants with severe bronchiolitis is associated with decline in intubation rates over a decade Intensive Care Med 2012;38(7):1177-1183 142 Donlan M, Fontela PS, Puligandla PS Use of continuous positive airway pressure (CPAP) in acute viral bronchiolitis: a systematic review Pediatr Pulmonol 2011;46(8):736-746 143 Milesi C, Essouri S, Pouyau R, et al 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 2017;43(2):209-216 144 Shein SL, Slain KN, Rotta AT, Milési C, Cambonie G High-flow nasal cannula flow rate in young infants with severe viral bronchiolitis: the question is still open Intensive Care Med 2019;45(1):134-135 145 Sarkar M, Sinha R, Roychowdhoury S, et al 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 2018;22(2):85-90 146 Chisti MJ, Salam MA, Smith JH, et al Bubble continuous positive airway pressure for children with severe pneumonia and hypoxaemia in Bangladesh: an open, randomised controlled trial Lancet 2015;386(9998):1057-1065 147 Hammer J, Numa A, Newth CJ Acute respiratory distress syndrome caused by respiratory syncytial virus Pediatr Pulmonol 1997;23(3):176-183 148 Cruces P, González-Dambrauskas S, Quilodrán J, et al Respiratory mechanics in infants with severe bronchiolitis on controlled mechanical ventilation BMC Pulm Med 2017;17(1):129 149 Hassinger AB, Breuer RK, Nutty K, Ma CX, Al Ibrahim OS Negative-pressure ventilation in pediatric acute respiratory failure Respir Care 2017’;62(12):1540-1549 150 Wang BC, Pei T, Lin CB, et al Clinical characteristics and outcomes associated with nasal intermittent mandatory ventilation in acute pediatric respiratory failure World J Crit Care Med 2018; 7(4):46-51 151 Baudin F, Emeriaud G, Essouri S, Beck J, Javouhey E, Guerin C Neurally adjusted ventilatory assist decreases work of breathing during non-invasive ventilation in infants with severe bronchiolitis Crit Care 2019;23(1):120 152 Baudin F, Emeriaud G, Essouri S, et al Physiological effect of prone position in children with severe bronchiolitis: a randomized cross-over study (BRONCHIO-DV) J Pediatr 2019;205: 112-119.e4 153 Roqué i Figuls M, Giné-Garriga M, Granados Rugeles C, Perrotta C, VilarÓ J Chest physiotherapy for acute bronchiolitis in paediatric patients between and 24 months old Cochrane Database Syst Rev 2016;2:CD004873 154 Mussman GM, Parker MW, Statile A, Sucharew H, Brady PW Suctioning and length of stay in infants hospitalized with bronchiolitis JAMA Pediatr 2013;167(5):414-421 155 Liet JM, Ducruet T, Gupta V, Cambonie G Heliox inhalation therapy for bronchiolitis in infants Cochrane Database Syst Rev 2015;(9):CD006915 156 Holman RC, Shay DK, Curns AT, Lingappa JR, Anderson LJ Risk factors for bronchiolitis-associated deaths among infants in the United States Pediatr Infect Dis J 2003;22(6):483-490 157 Byington CL, Wilkes J, Korgenski K, Sheng X Respiratory syncytial virus-associated mortality in hospitalized infants and young children Pediatrics 2015;135(1):e24-e31 158 Langley JM, Wang EE, Law BJ, et al Economic evaluation of respiratory syncytial virus infection in Canadian children: a Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study J Pediatr 1997;131(1 Pt 1):113-117 159 Willson DF, Landrigan CP, Horn SD, Smout RJ Complications in infants hospitalized for bronchiolitis or respiratory syncytial virus pneumonia J Pediatr 2003;143(suppl 5):S142-S149 160 Kho N, Kerrigan JF, Tong T, Browne R, Knilans J Respiratory syncytial virus infection and neurologic abnormalities: retrospective cohort study J Child Neurol 2004;19(11):859-864 161 Morrison AL, Gillis J, O’Connell AJ, Schell DN, Dossetor DR, Mellis C Quality of life of survivors of pediatric intensive care Pediatr Crit Care Med 2002;3(1):1-5 162 Shein SL, Slain KN, Clayton JA, McKee B, Rotta AT, WilsonCostello D Neurologic and functional morbidity in critically ill children with bronchiolitis Pediatr Crit Care Med 2017;18(12): 1106-1113 163 Regnier SA, Huels J Association between respiratory syncytial virus hospitalizations in infants and respiratory sequelae: systematic review and meta-analysis Pediatr Infect Dis J 2013;32(8): 820-826 164 Blanken MO, Rovers MM, Molenaar JM, et al Respiratory syncytial virus and recurrent wheeze in healthy preterm infants N Engl J Med 2013;368(19):1791-1799 165 Scheltema NM, Nibbelke EE, Pouw J, et al Respiratory syncytial virus prevention and asthma in healthy preterm infants: a randomised controlled trial Lancet Respir Med 2018;6(4):257-264 e5 Abstract: Viral bronchiolitis, most commonly caused by respiratory syncytial virus, is a common indication for pediatric intensive care unit (PICU) admission and a leading cause of global morbidity and mortality in young children National guidelines are available for treatment but are generally intended for non-ICU clinicians Treatment for critical bronchiolitis is predominantly supportive This chapter reviews the microbiology, epidemiology, pathophysiology, clinical presentation, current therapeutics, and common complications associated with critical bronchiolitis Key words: bronchiolitis, acute respiratory failure, high-flow nasal cannula, pulmonology, respiratory syncytial virus 50 Asthma STEVEN L SHEIN, RICHARD H SPEICHER, HOWARD EIGEN, AND ALEXANDRE T ROTTA PEARLS • Patients with severe acute asthma exacerbations should be promptly and aggressively managed in the emergency department with inhaled b-agonist agents, inhaled ipratropium bromide, oxygen, and a systemic corticosteroid Patients who fail to improve or who further deteriorate should be admitted to the intensive care unit for escalation of therapy and a higher level of monitoring • Standard treatments include administration of intravenous fluids, oxygen, b-agonist agents by intermittent or continuous nebulization, ipratropium bromide, parenteral corticosteroids, and intravenous infusion of a b2-agonist agent Other therapies available in the intensive care unit include intravenous infusions of magnesium sulfate and methylxanthine agents, and breathing helium-oxygen mixtures • Failure to respond to treatment can lead to further deterioration and the development of respiratory failure, necessitating noninvasive ventilatory support or even intubation and mechanical ventilation When needed, ventilation should be initiated with a strategy that avoids dynamic hyperinflation Select patients may benefit from inhalational anesthetic agents for bronchodilation, bronchoscopy to relieve airway obstruction or atelectasis resulting from mucous plugging, or extracorporeal life support • Aggressive medical treatment and a mechanical ventilation strategy that minimizes dynamic hyperinflation result in low morbidity and near-zero mortality rates in patients with critical or near-fatal asthma Asthma is a highly prevalent chronic disease that affects both children and adults It is the most common medical emergency in the pediatric population Despite adequate treatment and access to medical care, patients with asthma are at risk for episodic acute respiratory deterioration, commonly known as reactive airway disease exacerbations or asthma attacks These episodes vary greatly in severity, ranging from those that are easily managed in the outpatient setting by increasing corticosteroid and bronchodilator therapy to severe episodes with intense airway obstruction that rapidly evolve to respiratory failure Several terms are used to denote severe asthma attacks, including status asthmaticus, acute severe asthma, critical asthma, and near-fatal asthma Definitions vary among sources; many consider status asthmaticus to be an outdated term.1–5 For this text, acute severe asthma is defined as an asthma attack unresponsive to repeated doses of b-agonists and requiring hospital admission1,6; critical asthma is defined as acute severe asthma necessitating intensive care unit (ICU) admission7–9; and near-fatal asthma is defined as critical asthma that requires endotracheal intubation and mechanical ventilation.8 prevalence is approximately 11% to 13% and varies widely, from approximately 5% in some Asian and Eastern Europe countries to nearly 25% in parts of Central America, South America, Oceania, and the United Kingdom.11 The prevalence of asthma increased worldwide between 1990 and 2015.12 Asthma is a common reason for hospitalization, with approximately million pediatric asthma exacerbations and 150,000 pediatric asthma admissions occurring in the United States annually.13,14 It is also a common comorbidity among children hospitalized for other reasons, present in 21.8% of all-cause pediatric hospitalizations.15 In some countries, including the United States, asthma hospitalizations are becoming less frequent, but admissions are increasing in other developed countries.14,16,17 Even in areas where the incidence of acute severe asthma is decreasing, admissions to the pediatric ICU (PICU) are increasing In New Jersey, the incidence of critical asthma increased from 0.09 to 0.31 per 1000 children between 1992 and 2006, and 35% of acute severe asthma admissions received ICU care during the final years of the study period.18 In Ohio, ICU utilization averages approximately 25% among six children’s hospitals, with greater than 40% of hospitalized children receiving ICU care at some centers.19 Rates of positive-pressure ventilation for asthma have increased recently in the United States and Spain.14,16 Among critical asthma patients in the United States, 5% to 12% are treated with invasive mechanical ventilation, and 3% to 5% are treated with noninvasive ventilation.18,20,21 Epidemiology and Risk Factors Asthma is the most common chronic illness in childhood, affecting 9.5% of all children in the United States.10 Overall global 552 ... intensive care unit include intravenous infusions of magnesium sulfate and methylxanthine agents, and breathing helium-oxygen mixtures • Failure to respond to treatment can lead to further deterioration... Mayfield S, Martin S, Schibler A The effect of high flow nasal cannula therapy on the work of breathing in infants with bronchiolitis Pediatr Pulmonol 2015;50(7):713-720 125 Milesi C, Baleine J,... Newth CJL, Khemani RG The relationship between high flow nasal cannula flow rate and effort of breathing in children J Pediatr 2017;189:66-71.e3 127 McKiernan C, Chua LC, Visintainer PF, Allen H