Cardiac Echocardiography Findings in Previously Healthy Hospitalized Children With Bronchiolitis - a Retrospective Study

Abstract

Objective: Children less than two years of age with a prolonged or severe course of bronchiolitis are usually referred for Echocardiographic evaluation during hospitalization. Our aim was to assess the yield of Echocardiography (Echo) in these children and to assess possible characteristics predicting positive Echo findings.

Study design: This retrospective study over 10 years included all children under two years of age admitted with acute bronchiolitis. Data was collected using the MDClone query tool. Children with abnormal Echo findings (positive Echo) were compared to a control group (comprised of all other admitted patients with bronchiolitis, and to bronchiolitis patients referred for cardiologic evaluation and found to have normal Echo).

Results: Echocardiography was performed in 251/2137 eligible patients with a clinical diagnosis of bronchiolitis. Twenty-six of 251 had abnormal findings, 20 of mild and six of moderate to severe clinical significance. Younger age at diagnosis, Arab ethnicity, higher respiratory rate, lower pH, higher pCO₂, longer hospital length of stay, PICU admission and mechanical ventilation were more likely to be associated with positive Echo findings.

Conclusion: Although Echocardiographic assessment of healthy infants during bronchiolitis is normal in the vast majority of children, the noninvasive, non-irradiating nature of the assessment, combined with the possible detrimental repercussions of a missed congenital cardiac anomaly, suggests performing Echocardiography during an atypical or severe course of bronchiolitis. However, larger studies are required to assess the yield of Echocardiography in bronchiolitis.

Keywords: Echocardiography; bronchiolitis; congenital heart disease.