Apnea risk low in most infants with bronchiolitis

In infants presenting with bronchiolitis (inflammation of the lungs), the risk of apnea (brief pauses in breathing) is less than 3 percent, study findings suggest. However, the risk is higher in very young and preterm infants.

Dr. Marvin B. Harper and colleagues at Boston’s Children’s Hospital evaluated the cases of 691 infants admitted to their institution with bronchiolitis. Nineteen of the infants (2.7 percent) developed apnea, the researchers report in the Annals of Emergency Medicine.

The team developed, a priori, a list of risk criteria for identifying infants at high risk for apnea: those born full term but less than one month of age; those born preterm (less than 37 weeks gestation) and younger than 48 weeks post-conception; or those who have had a previous witnessed episode of apnea.

All 19 infants with apnea met these criteria, the investigators report.

“No infant classified as low risk subsequently developed apnea,” the team reports. Hence, the risk criteria had a sensitivity of 100 percent and a negative predictive value of 100 percent.

Harper and colleagues acknowledge that admitting an infant based on his risk criteria might lead to unnecessary hospitalizations, but this drawback is “likely outweighed by the serious consequences for discharging a patient who subsequently develops apnea.”

SOURCE: Annals of Emergency Medicine October 2006.

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