Introduction
Acute bronchiolitis is a lower airway disease frequently seen in
children under the age of two years and generally characterized by
inflammation of the small airways caused by viral agents. Onset occurs
with upper airway infection findings such as cough and nasal discharge,
followed by wheeze, prolonged expiration, rapid breathing, and
retractions in the chest.1,2 Rapid respiration,
retractions caused by the functioning of the accessory respiratory
muscles, and low oxygen saturation are evaluated as severe disease
findings.1
Acute bronchiolitis is more common in boys, in children who are not
breastfed, in those exposed to cigarette smoke, and in the children of
families of low socioeconomic status.2 The course of
the disease is severe in some patients, and may require hospitalization
and intensive care. Children with histories of premature birth, babies
younger than three months, and patients with cardiovascular,
neurological, or pulmonary diseases and immune deficiency are at risk of
developing acute bronchiolitis.1,2 Living under
crowded conditions and the presence of siblings have also been described
as risk factors for development of severe
bronchiolitis.3,4 Since maternal smoking during
pregnancy increases hospitalization rates and results in a severe course
of disease in patients with bronchiolitis, respiratory support with
mechanical ventilation may be required.5,6 A history
of airway disease in the perinatal and neonatal period has been reported
to increase the risk of bronchiolitis and
hospitalization.4 It has also been suggested that
genetic factors may affect a severe disease course.7
Identifying factors increasing the risk of acute bronchiolitis
development in patients with no chronic disease is important in terms of
standardizing the frequency of follow-ups and hospitalization
indications in bronchiolitis patients, and in terms of deciding to
intervene early in case of at-risk patients. The purpose of the present
study was to determine predictive individual, familial, and
environmental risk factors for development of severe bronchiolitis in
healthy-appearing acute bronchiolitis patients with no previous history
of chronic disease.