IMPORTANCE: Hospitalizations of infants for bronchiolitis are common and costly. Despite the high incidence and resource burden of bronchiolitis, the mainstay of treatment remains supportive care, which frequently includes nasal suctioning. OBJECTIVE: To examine the association between suctioning device type and suctioning lapses greater than 4 hours within the first 24 hours after hospital admission on length of stay (LOS) in infants with bronchiolitis. DESIGN: Retrospective cohort study. Data were extracted from the electronic health record. SETTING: Main hospital and satellite facility of a large quaternary care children's hospital from January 10, 2010, through April 30, 2011. PARTICIPANTS: A total of 740 infants aged 2 to 12 months and hospitalized with bronchiolitis. MAIN OUTCOME MEASURE: Hospital LOS. RESULTS: In the multivariable model adjusted for inverse weighting for propensity to receive deep suctioning, increased deep suction as a percentage of suction events was associated with increased LOS with a geometric mean of 1.75 days (95% CI, 1.56-1.95 days) in patients with no deep suction and 2.35 days (2.10-2.62 days) in patients with more than 60% deep suction. An increased number of suctioning lapses was also associated with increased LOS in a dose-dependent manner with a geometric mean of 1.62 days (95% CI, 1.43-1.83 days) in patients with no lapses and 2.64 days (2.30-3.04 days) in patients with 3 or 4 lapses. CONCLUSIONS AND RELEVANCE: For patients admitted with bronchiolitis, the use of deep suctioning in the first 24 hours after admission and lapses greater than 4 hours between suctioning events were associated with longer LOS.
IMPORTANCE: Hospitalizations of infants for bronchiolitis are common and costly. Despite the high incidence and resource burden of bronchiolitis, the mainstay of treatment remains supportive care, which frequently includes nasal suctioning. OBJECTIVE: To examine the association between suctioning device type and suctioning lapses greater than 4 hours within the first 24 hours after hospital admission on length of stay (LOS) in infants with bronchiolitis. DESIGN: Retrospective cohort study. Data were extracted from the electronic health record. SETTING: Main hospital and satellite facility of a large quaternary care children's hospital from January 10, 2010, through April 30, 2011. PARTICIPANTS: A total of 740 infants aged 2 to 12 months and hospitalized with bronchiolitis. MAIN OUTCOME MEASURE: Hospital LOS. RESULTS: In the multivariable model adjusted for inverse weighting for propensity to receive deep suctioning, increased deep suction as a percentage of suction events was associated with increased LOS with a geometric mean of 1.75 days (95% CI, 1.56-1.95 days) in patients with no deep suction and 2.35 days (2.10-2.62 days) in patients with more than 60% deep suction. An increased number of suctioning lapses was also associated with increased LOS in a dose-dependent manner with a geometric mean of 1.62 days (95% CI, 1.43-1.83 days) in patients with no lapses and 2.64 days (2.30-3.04 days) in patients with 3 or 4 lapses. CONCLUSIONS AND RELEVANCE: For patients admitted with bronchiolitis, the use of deep suctioning in the first 24 hours after admission and lapses greater than 4 hours between suctioning events were associated with longer LOS.
Authors: Stephen Muething; Pamela J Schoettker; Wendy E Gerhardt; Harry D Atherton; Maria T Britto; Uma R Kotagal Journal: J Pediatr Date: 2004-06 Impact factor: 4.406
Authors: Uma R Kotagal; James M Robbins; Narendra M Kini; Pamela J Schoettker; Harry D Atherton; Mark S Kirschbaum Journal: Chest Date: 2002-06 Impact factor: 9.410
Authors: Eugenio Baraldi; Marcello Lanari; Paolo Manzoni; Giovanni A Rossi; Silvia Vandini; Alessandro Rimini; Costantino Romagnoli; Pierluigi Colonna; Andrea Biondi; Paolo Biban; Giampietro Chiamenti; Roberto Bernardini; Marina Picca; Marco Cappa; Giuseppe Magazzù; Carlo Catassi; Antonio Francesco Urbino; Luigi Memo; Gianpaolo Donzelli; Carlo Minetti; Francesco Paravati; Giuseppe Di Mauro; Filippo Festini; Susanna Esposito; Giovanni Corsello Journal: Ital J Pediatr Date: 2014-10-24 Impact factor: 2.638