학술논문

Critical care of severe bronchiolitis during shortage of ICU resources
Document Type
article
Source
EClinicalMedicine, Vol 69, Iss , Pp 102450- (2024)
Subject
RSV
NICU
PICU
Respiratory failure
Outbreak
Infant
Medicine (General)
R5-920
Language
English
ISSN
2589-5370
Abstract
Summary: Large seasonal outbreaks of bronchiolitis put pressure on healthcare systems and particularly on intensive care units (ICUs). ICU admission is necessary to provide respiratory support to the severest cases, otherwise bronchiolitis can result in substantial mortality. ICU resources are often insufficient and there is scant evidence to guide the ICU clinical management. Most available studies do not cover the ICU-admitted cases and do not consider the associated public health issues. We review this topic through a multidisciplinary approach from both the clinical and public health perspectives, with an analysis based on pathophysiology and cost-effectiveness. We suggest ways to optimise respiratory care, minimise ICU stay, “protect” ICU beds and, whenever possible, make them available for other critically ill children. We also provide guidance on how to prepare ICUs to work under stressful conditions due to outbreaks and to reduce the risk of nosocomial cross-contamination, particularly in ICUs caring for high-risk children. Funding: None.