Factors Associated with the Use of High-Flow Nasal Cannula, Endotracheal Intubation, and Length of Hospital Stay Among Children with Bronchiolitis at Thanyaburi Hospital
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Abstract
Background: Bronchiolitis is the most common lower respiratory tract infection in children under 24 months and a major cause of hospitalization. Standard treatment is mainly supportive, while the use of high-flow nasal cannula (HFNC) has become increasingly popular for patients with severe symptoms. However, data from community hospitals in Thailand remain limited.
Objective: To identify factors associated with HFNC therapy, respiratory failure requiring intubation, and length of hospital stay (LOS) among children under 24 months with bronchiolitis admitted to Thanyaburi Hospital.
Methods: A retrospective cohort study was conducted among children under 24 months hospitalized with acute bronchiolitis between January 1, 2019 and December 31, 2023. Factors associated with HFNC use and respiratory failure requiring intubation were analyzed using Poisson regression, and factors associated with LOS were analyzed using quantile regression.
Results: A total of 648 patients were included. Most were male (61.4%) with a mean age of 11.1 ± 6.6 months. HFNC therapy was used in 35.2% of patients. Factors associated with HFNC use included bronchodilator nebulization (aRR 13.02; 95% CI 1.86–91.18), inhaled corticosteroid therapy (aRR 1.56; 95% CI 1.31–1.87), and intravenous corticosteroids (aRR 2.03; 95% CI 1.68–2.46), whereas low-flow oxygen and COVID-19 infection were associated with reduced risk. Intubation occurred in 1.9% and was associated with age <12 months and intravenous corticosteroid use. The median LOS was 5 days [IQR 4–7], and longer hospitalization was associated with age <12 months, cerebral palsy, COVID-19 infection, and corticosteroid use.
Conclusion: Age <12 months and corticosteroid use, particularly intravenous, were associated with Intubation and prolonged hospitalization. Early risk assessment and cautious corticosteroid use are essential in community hospital settings.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
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