Admission rate for bronchiolitis of newborns and infants in Italian neonatal intensive care units in 2021: a survey of the Italian Society of Neonatology - Intensive Care of Early Childhood Study Group

PMCID: PMC12175376

PMID: 40528201

DOI: 10.1186/s13052-025-01977-x

Journal: Italian journal of pediatrics

Publication Date: 2025-6-17

Authors: Decembrino N, Leonardi R, Fedeli T, Conte L, Distefano C, et al.

Key Points

• NICUs are emerging as critical alternative care centers during PICU bed shortages, particularly during RSV epidemics
• 67% response rate from Italian NICUs, with 70% admitting children > 44 weeks postconceptional age
• Recommendation to develop "extended NICUs" with specialized pediatric critical care training to address regional PICU capacity limitations

Summary

This Italian survey examined the role of Neonatal Intensive Care Units (NICUs) in managing pediatric respiratory syncytial virus (RSV) bronchiolitis during periods of Pediatric Intensive Care Unit (PICU) bed shortages. With a 67% response rate (78/117 NICUs), the study revealed that NICUs are increasingly serving as critical care alternatives for infants and toddlers requiring advanced respiratory support during RSV epidemics.

The research highlighted significant variations in NICU practices, with 70% of units routinely admitting children over 44 weeks postconceptional age. In 2021, 40% of NICUs admitted fewer than 10 bronchiolitis cases, with respiratory distress syndrome (92%) being the primary admission reason. Respiratory support predominantly included high-flow oxygen (87%) and non-invasive ventilation (60%), with only 10% of patients requiring invasive ventilation. Notably, treatment adherence was suboptimal, with frequent use of inhaled steroids (46%), bronchodilators, and antibiotics that deviate from standard guidelines.