Severity of bronchiolitis in infants is associated with their parents'
tobacco habit
Abstract
Objectives: Risk factors for severe acute bronchiolitis in previously
healthy infants are scarcely known. This study investigated the effect
of tobacco smoke exposure among severely Pediatric Intensive Care Unit
(PICU) patients. Design: A prospective epidemiological observational
study Setting: Tertiary pediatric medical center. Pediatric Intensive
Care Unit (PICU) of Children’s University Hospital La Paz Patient
selection: Infants with bronchiolitis younger than 2 years of age during
the October 2017 to March 2018 outbreak Methodology: On admission,
parents were asked whether they smoked. In children who required
invasive mechanical ventilation, endotracheal aspirate was collected at
the time of intubation. Results: A total of 102 patients with
bronchiolitis were studied. Among these, 14 (47%) of 30 infants whose
parents smoked required invasive mechanical ventilation vs. 14 (19%) of
72 whose parents were nonsmokers (p=0.007) (RR 2.4; 95% CI 1.3–4.4).
Among patients on invasive mechanical ventilation, 10 (71%) of 14
infants with secondhand smoke exposure presented PBI vs. 3 (21%) of 14
in the unexposed (p=0.012) (RR 3.3; 95% CI 1.2–9.6). PICU stay was 3
(IQR 3-6) days in infants whose parents didn´t smoke, and 5 (IQR 3-11)
days in infants whose parents smoked (p=0.01). Conclusions: Secondhand
smoke exposure is an additional high risk for pulmonary bacterial
superinfection, invasive mechanical ventilation and PICU length of stay
in infants with severe acute bronchiolitis