Evidence map›Paper›PMID 40987496›Full record

Observational studyBMJ paediatrics open2025

Application of the 2023 Italian guidelines for respiratory support management in acute viral bronchiolitis: a retrospective study.

Domenico Paolo La Regina, Brigitte Fauroux, Rocco Di Gioia, Simona Marra, Laura Petrarca, Enrica Mancino, Maria Giulia Conti, Luigi Matera, Greta Di Mattia, Antonella Frassanito and 5 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ paediatrics open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Domenico Paolo La ReginaMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.ORCID http://orcid.org/0000-0002-8297-8920
Brigitte FaurouxNoninvasive Ventilation and Sleep Unit, Necker-Enfants Malades Hospitals, Paris, Île-de-France, France.ORCID http://orcid.org/0000-0001-6092-2662
Rocco Di GioiaMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Simona MarraMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Laura PetrarcaMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Enrica MancinoMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Maria Giulia ContiMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Luigi MateraMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Greta Di MattiaMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Antonella FrassanitoMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Enea BonciMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Benedetto D'AgostinoMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Raffaella NennaMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Paola PapoffMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy.
Fabio MidullaMaternal Child and Urological Sciences, Sapienza University of Rome, Rome, Rome, Italy midulla@uniroma1.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the impact of the 2023 Italian guidelines on respiratory support management for acute viral bronchiolitis by comparing the use of low-flow oxygen (LFO) and high-flow nasal cannula (HFNC) therapies during the 2022-2023 and 2023-2024 epidemic seasons.

designA retrospective, single-centre observational study.

settingThe paediatric emergency department of Policlinico Umberto I, Rome, Italy. PATIENTS: A total of 202 infants (<12 months) with hypoxaemia due to acute viral bronchiolitis were hospitalised during the study periods. Eight patients were excluded due to chronic conditions or missing data.

interventionsThe study compared LFO as a first-line therapy and HFNC as a second-line option in cases of LFO failure, before (2022-2023) and after (2023-2024) the guideline update.

main outcome measuresRates of LFO and HFNC use, treatment failure, intubation, intensive care unit (ICU) admission, length of hospitalisation and oxygen therapy duration.

resultsHFNC use as a first-line therapy decreased from 43.5% to 5.5%, while LFO use increased from 56.5% to 94.5%. LFO failure rates dropped significantly from 50% to 23%. No significant changes were observed in HFNC failure rates (12.5% vs 16.7%), ICU admissions or intubation rates. The average hospital stay decreased from 5.1±2.3 to 4.1±2.0 days, with a concomitant reduction in oxygen therapy duration.

conclusionsThe 2023 Italian guidelines significantly reduced inappropriate HFNC use and hospital stay length without compromising patient outcomes. These findings support the step-up approach, emphasising LFO as the preferred first-line therapy.

Indexed as

Bronchiolitis, ViralGuideline AdherenceOxygen Inhalation TherapyAcute DiseaseCannulaFemaleHospitalizationHumansHypoxiaInfantItalyLength of StayMalePractice Guidelines as TopicRetrospective StudiesHypoxiaInfant

Identifiers

PMID40987496
PMCPMC12458878

What OpenQuestion holds

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Registered trials

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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.