Bronchiolitis, first protocol for the management of serious newborns

Bronchiolitis, first protocol for the management of serious newborns

First protocol in the world for the management of newborns suffering from bronchiolitis and hospitalized in intensive care units. I study, published in The Lancet eClinical Medicinehas proven to be a turning point in effectively controlling a problem that leads to the deaths of hundreds of thousands of children every year.

Respiratory syncytial virus and bronchiolitis

Bronchiolitis is a fearful respiratory infection that especially attacks very young children and newborns. In the most serious cases, it can be lethal, as it can cause very critical respiratory failure. Caused above all by RSV (Respiratory Syncytial Virus), it is an extremely infectious seasonal pathology which, both in Europe and in North America – thanks to the cold and contagiousness in nursery schools – causes many hospitalizations in pediatric and neonatal intensive care units (ICU ). In light of this, the work promoted by Daniele De Lucafull professor of Neonatology at Paris Saclay University, together with other researchers and experts from various Italian and French universities, including Maria Rosaria Gualanoassociate professor of Hygiene at UniCamillus University, with the important role of coordinator and organizational and executive seniorship.

Who and what are the guidelines for?

The objectives of these guidelines are: to prepare hospital teams to recognize the most serious cases to be transported to emergency departments; identify the criteria that can diagnose various levels of severity of the pediatric patient; manage the patient through different and appropriate methods of nutrition, hydration, supplementation, as well as pharmacological therapy, trying to avoid intubating small patients, and instead implementing advanced non-invasive respiratory assistance methods; ensure the best control of the spread of the virus thanks to appropriate personal protective equipment, forms of safety isolation, filters and specific techniques.

All this in order to avoid the collapse of the ICU and to protect newborns who find themselves in more delicate situations (very small, with a weaker immune system and/or with pre-existing comorbid conditions). “The protocol proposed by our study becomes crucial for the management of small patients who present fragility and become more severe and complex cases to manage – comments Professor Gualano – By combining research based on the best reference studies with data from our daily reality, we have been able to reach this important milestone, so we expect excellent results from applications in all contexts of this type, both from the point of view of improving clinical outcomes and from the economic one, given the good level of cost-effectiveness of this approach”.

The role of Italian experts

In addition to the “Paris Saclay” University of Paris and the “UniCamillus” University of Rome, the Pediatric Intensive Care Units of the “Bambino Gesù” of Rome and the University Hospital of Padua also participated in the study, as well as the Foundation “Gemelli” Polyclinic of Rome and the Center for Research and Studies on Leadership of the “Cattolica del Sacro Cuore” University of Rome. The study in question can be consulted online on the website of The Lancet eClinical Medicine.

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