Dataset Information

National survey of feasibility of NIV trials for management of children with bronchiolitis.

ABSTRACT: Background:Bronchiolitis is a major cause of admission to hospital in children. Non-invasive ventilation (NIV) support with continuous positive airway pressure (CPAP) or high-flow nasal cannula (HFNC) oxygen is routinely used for infants in the UK with bronchiolitis. Objective:To establish UK paediatric practice regarding management of bronchiolitis, and to explore issues pertinent to the design of a potential future randomised controlled trial of NIV. Design:Screening logs were completed in hospitals in England capturing information on paediatric bronchiolitis admissions. An online national survey of clinical practice was disseminated to healthcare professionals (HCPs) across the UK to ascertain current management strategies. Results:Screening logs captured data on 393 infants from 8 hospitals. Reasons for admission were most commonly respiratory distress and/or poor fluid intake. Oxygen was administered for 54% of admissions. Respiratory (CPAP and HFNC) and non-respiratory support administered varied considerably. The national survey was completed by 111 HCPs from 76 hospitals. Data were obtained on criteria used to commence and wean NIV, responsibilities for altering NIV settings, minimum training requirements for staff managing a child on NIV, and numbers of trained staff. Most centres were interested in and capable of running a trial of NIV, even out of normal office hours. Conclusions:Respiratory and non-respiratory management of bronchiolitis in UK centres varies widely. A trial of HFNC oxygen therapy in this group of patients is feasible and HCPs would be willing to randomise patients into such a trial. Future work should focus on defining trial eligibility criteria.

SUBMITTER: Rosala-Hallas A

PROVIDER: S-EPMC7592239 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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National survey of feasibility of NIV trials for management of children with bronchiolitis.

Rosala-Hallas Anna A Jones Ashley P AP Bedson Emma E Compton Vanessa V Fernandes Ricardo M RM Lacy David D Lyttle Mark D MD Peak Matthew M Thorburn Kent K van Miert Clare C Woolfall Kerry K McNamara Paul S PS

BMJ paediatrics open 20201027 1

<h4>Background</h4>Bronchiolitis is a major cause of admission to hospital in children. Non-invasive ventilation (NIV) support with continuous positive airway pressure (CPAP) or high-flow nasal cannula (HFNC) oxygen is routinely used for infants in the UK with bronchiolitis.<h4>Objective</h4>To establish UK paediatric practice regarding management of bronchiolitis, and to explore issues pertinent to the design of a potential future randomised controlled trial of NIV.<h4>Design</h4>Screening logs ...[more]

PMID: 33134562

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Project description:The aim of this study was to obtain national data regarding adherence to national guidelines for aetiological investigations for hearing loss in children and highlight any variations in practice. Information was also collected on possible factors affecting lack of adherence. An online questionnaire based on the national guidelines for aetiological investigations for deafness was designed. The questionnaire was distributed to the leads of all the Newborn Hearing Screening Programme (NHSP) sites across England through the Medical Research Council Hearing & Communication Group. The questionnaire was sent to 100 recipients; from this 52 responses were obtained. Variability in the investigations offered for hearing loss. There was a 52% response rate. Analysis of the responses showed that audiovestibular physicians and paediatricians in audiology were more likely than other specialists to request level 1 investigations (investigations that are recommended to be offered in all cases). Respondents from London and the North West were more likely to request level 1 investigations compared with those from other regions. In all, 14 of the 19 audiovestibular physicians and paediatricians in audiology requested level 1 investigations routinely, but only 11 of 33 from other specialties did likewise. Of the 20 respondents from London and the Northwest, 15 requested level 1 investigations routinely, whereas only 10 of the 32 respondents from the other regions did the same. The difference was statistically significant in both cases. The geographical variation was specially marked for family audiograms and MRI. There is significant variation from the national guidelines in requesting aetiological investigations for permanent hearing impairment (PHI) in children, depending on the specialty of the clinician and the geographical region, these variations appear partly to be due to the availability of local resources but also due to lack of awareness of the importance of some investigations.

Dataset Information

National survey of feasibility of NIV trials for management of children with bronchiolitis.

Publications

National survey of feasibility of NIV trials for management of children with bronchiolitis.

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