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Master Thesis

Prevalence and risk factors of discomfort in infants with severe bronchiolitis

Abstract : Objective - To assess the prevalence of discomfort in infants with severe bronchiolitis supported by noninvasive ventilation and to identify its potential risk factors. Methods - A single-center retrospective observational study conducted over a 5-month period. All the infants aged ≤ 12 months admitted to the Pediatric Intensive Care Unit (PICU) during the study period with a clinical diagnosis of bronchiolitis and supported by any type of noninvasive ventilation (including High- Flow Nasal Cannula (HFNC), Continous Positive Airway Pressure (CPAP) or Bilevel Positive Airway Pressure (BiPAP)) during ICU stay were included. Discomfort was assessed using the EDIN (Echelle de Douleur et d’Inconfort du Nouveau-né) scale, collected by nurses every 4 to 6 hours during PICU hospitalization.Results - 91 infants (median age 34 days [Interquartile IQR 19-55], 52 (57%) boys) were included in our study. Thirty-one (34%), 35 (39%) and 23 (25%) were supported by HNCF, CPAP and BiPAP at admission, respectively. Overall, patients had a median EDIN score at 2.9 (SD 2.3), 2.3 (SD 2.1) and 2.3 (SD 2.0) on day 1, 2 and 3, respectively. There was no difference in the demographic, biological and clinical data according to the degree of discomfort on day 1. On day 1 and 2, patients supported by BiPAP had a higher EDIN score compared to other patients (3.3 (SD 2.5) versus 2.6 (SD 2.2) on day 1 and 2.9 (SD 2.1) versus 2.3 (SD 2.2) on day 2, both p < 0.001) (Figure 2A). Conclusion - Patients with severe bronchiolitis and supported by any type of noninvasive ventilation have a low degree of discomfort during the first three days of ICU stay. As compared to patients supported by HFNC or CPAP, patients requiring bilevel noninvasive ventilation seems to have a higher degree of discomfort, while we found no correlation between the level of discomfort and the degree of respiratory distress.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03355879
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Submitted on : Monday, September 27, 2021 - 3:45:16 PM
Last modification on : Thursday, September 30, 2021 - 3:24:06 AM

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  • HAL Id : dumas-03355879, version 1

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Justine Leboucher Berlendis. Prevalence and risk factors of discomfort in infants with severe bronchiolitis. Human health and pathology. 2021. ⟨dumas-03355879⟩

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