Introduction
Bronchiolitis affects 30% of infants under 24 months of age
(~480000 children) every winter in France, with a low
mortality rate (2.4-2.6 / 100000 births) 1,2,3.
However, bronchiolitis leads to a high burden that importantly impacts
the healthcare system every winter. Bronchiolitis is mostly mild and
resolves spontaneously within a few days, but in France, 2 to 3% of the
infants will have a severe form of the disease that require
hospitalization. The average cost of hospitalization for the first
episode of bronchiolitis is 5671\euro (± 3354) and the average length
of stay (LOS) is 3 days (±3) 4. The latest
international guidelines for in-hospital management of children with
bronchiolitis recommend the use of sole supportive treatments: feeding
and/or oxygen supplementation for infants who require it. The referral
for airway clearance techniques (ACT) application is no longer
recommended worldwide since no clear benefit have been reported3,5,6,7.
Several features have been linked with a higher LOS including a
premature birth <36 weeks of gestational age (GA), and the
presence of comorbidities 5. Beyond these criteria,
the nutrition is a determining factor in managing the LOS of these
infants 8,9. On the other hand, the factors associated
with the time to recover adequate feeding (LOFR) are poorly known.
Nonetheless, the latest French health authority guidelines (HAS)5 proposed a new algorithm for hospital referring
including feeding assessment further reinforcing the need to investigate
the factors related with feeding in this population.
The main objective of this study was to investigate the factors
associated with (1) the LOFR, and (2) the LOS. Among these factors, we
aimed to investigate the indications for bronchiolitis ACT referring in
our center.