Abstract
Introduction: Blood gas analysis (BGA) is frequently used in the management of acute bronchiolitis with little evidence. BGA may be a marker of disease severity as indicated by our previous pilot study although a recent study showed endtidal CO2 in emergency department (ED) was not.
Aims: Investigate BGA as a marker of severity measured by length of stay (LOS) and admission to high dependence unit (HDU/ITU).
Methods: Retrospective observational study over two bronchiolitis seasons (2014/15 and 2015/2016) of infants (age <1year) admitted via ED to a tertiary teaching hospital using patient electronic medical records. Children transferred directly to HDU/ITU were excluded. Using logistical regression models (STATA/IC 12.1) the association between capillary CO2 and markers of disease severity (LOS and HDU/ITU) was examined.
Results: 332 children were included (mean age 0.35 years, 53% male, 23% premature, 72% RSV positive) of whom 158 infants had BGA with 526 BGA episodes overall (mean first and maximum CO2 per infant was 5.9kPa (SD1.1) and 6.4kPa (SD1.5) respectively). Median LOS was 3 days (IQR3). A rise in CO2 (>7.0kPa) for any BGA during admission (seen in 23%) was significantly associated with younger age (OR 0.005 (95%CI 0.0007, 0.03); p<0.0001) and use of supplemental oxygen (OR 1.9 (95%CI 1.1, 3.3); p=0.033) although not to the amount of oxygen supplied. 62% (98/158) infants had BGA in ED. CO2 >7kPa in ED (N=26/98) was significantly associated with length of hospital stay (IRR 1.4 (95%CI 1.1,1.8); p=0.008) and HDU/ITU admission (OR 2.8 (95%CI 1.2,6.6); p=0.019).
Conclusion: Our results suggest that BGA may be a possible marker of severity in future intervention trials for bronchiolitis.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, OA3605.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018