SynthesisPediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2004
Efficacy of interventions for bronchiolitis in critically ill infants: a systematic review and meta-analysis.
Synthesis in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 7 syntheses or guidelines pooled it, 116 citations in OpenAlex.
- Continuous positive airway pressure (CPAP) for acute bronchiolitis in children.The Cochrane database of systematic reviews · 2019Pooled it
- Heliox inhalation therapy for bronchiolitis in infants.The Cochrane database of systematic reviews · 2015Pooled it
- Surfactant therapy for bronchiolitis in critically ill infants.The Cochrane database of systematic reviews · 2015Pooled it
- Bronchiolitis.BMJ clinical evidence · 2011Pooled it
- Bronchiolitis.BMJ clinical evidence · 2007Pooled it
- Surfactant therapy for acute respiratory failure in children: a systematic review and meta-analysis.Critical care (London, England) · 2007Pooled it
- Clinical review: a systematic review of corticosteroid use in infections.Critical care (London, England) · 2006Pooled it
- RSV-encoded NS2 promotes epithelial cell shedding and distal airway obstruction.The Journal of clinical investigation · 2014Trial
- A prospective randomised trial comparing nasogastric with intravenous hydration in children with bronchiolitis (protocol): the comparative rehydration in bronchiolitis study (CRIB).BMC pediatrics · 2010Trial
- Inhaled L-Epinephrine As a Rescue Therapy in Critical Bronchiolitis.Critical care explorations · 2026Article
- Evaluation of Intestinal Permeability in Children Diagnosed With Bronchiolitis in Pediatric Emergency Department: A Cross-Sectional Study.Pediatric pulmonology · 2025Article
- Short-Term Effects of Conventional Chest Physiotherapy and Expiratory Flow Increase Technique on Respiratory Parameters, Heart Rate, and Pain in Mechanically Ventilated Premature Neonates: A Randomized Controlled Trial.Healthcare (Basel, Switzerland) · 2024Article
- Acute Viral Bronchiolitis: A Narrative Review.Journal of pediatric intensive care · 2023Review
- Sustainability of evidence-based practices in the management of infants with bronchiolitis in hospital settings - a PREDICT study protocol.BMC health services research · 2022Article
- Evaluation of reported medical services provided to pediatric viral bronchiolitis diagnoses during the COVID-19 pandemic.Respiratory medicine and research · 2022Observational
- Airway Resistance and Respiratory Compliance in Children with Acute Viral Bronchiolitis Requiring Mechanical Ventilation Support.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2021Article
- Rational use of mucoactive medications to treat pediatric airway disease.Paediatric respiratory reviews · 2020Review
- Article
- Language Barriers and the Management of Bronchiolitis in a Pediatric Emergency Department.Academic pediatrics · 2020Article
- Implementing evidence-based practices in the care of infants with bronchiolitis in Australasian acute care settings: study protocol for a cluster randomised controlled study.BMC pediatrics · 2018Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundViral bronchiolitis is the leading cause of respiratory failure among infants in the United States. Currently, the mainstay of treatment is supportive care. The effectiveness of treatments used for mechanically ventilated infants with bronchiolitis is unclear.
objectiveTo evaluate the strength of the evidence supporting the use of currently available treatments for critically ill infants with bronchiolitis. DATA SOURCE: We searched PubMed, citations of relevant articles, personal files, and conference proceedings, and we contacted experts in the field. STUDY SELECTION: Randomized, controlled trials evaluating any therapy for bronchiolitis that included children in an intensive care unit. DATA EXTRACTION: Two reviewers independently extracted data and assessed methodologic quality. DATA SYNTHESIS: A total of 2,319 citations were screened, and 16 randomized, controlled trials were included. There were three trials of surfactant, three of ribavirin, three of immune globulin, three of systemic corticosteroids, and one each of vitamin A, interferon, erythropoietin, and heliox. A meta-analysis of the three surfactant studies showed a strong trend toward a decrease in duration of mechanical ventilation of 2.58 days (95% confidence interval, -5.34 to 0.18 days; p =.07) and a significant decrease of 3.3 intensive care unit days (95% confidence interval, -6.38 to -0.23 days; p =.04). A meta-analysis of the three systemic corticosteroid studies showed no overall effect on duration of mechanical ventilation when all three trials were combined (-0.62 day; 95% confidence interval, -2.78 to 1.53 days; p =.57). We identified one published meta-analysis of three ribavirin studies showing a significant decrease in ventilator days with ribavirin (-1.2 days; 95% confidence interval, -0.2 to -3.4 days; p =.2).
conclusionsCurrently, there are no clearly effective interventions available to improve the outcome of critically ill infants with bronchiolitis. Surfactant seems to be a promising intervention, and corticosteroids or ribavirin may also be beneficial.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.