Öz
Giriş
Bronşiolit için birçok farmakolojik tedavinin faydası tartışma konusu olduğundan, akut bronşiolit için uygulanması kolay daha etkili tedavi yöntemlerinin araştırılması konusu güncelliğini korumaktadır.
Yöntemler
Bu çalışmada; iki yaşından küçük, solunum klinik skoru (RKS) ≥4 puan olan ve ilk akut bronşiyolit atağıyla gelen çocuklara nebulize salbutamol + artı standart oksijen(S) ve yüksek akışlı nazal kanül oksijen tedavisi (HF) tedavileri uygulandı.
Bulgular
Yetmiş iki hastanın ortalama yaşı 7,8±0,4 idi ve %59,7’si altı aydan küçüktü. Hastaların kabul anındaki ortalama RKS’si 8,42±2,026 puandı. İlk saatten itibaren 1-2-4-8 saatte değerlendirilen ortalama RKS skorlarında anlamlı bir düşüş gözlendi (p<0,05). Hastanede kalış süresi ve oksijen tedavisinin süresi ortalamaları sırasıyla 70±64.6 (4-288) ve 67,7±62,2 (4-264) saatti. Taburcu olduktan sonraki ilk birkaç gün içinde hastaların %50’si tekrar çocuk acil servisine (PED) başvurdu. Ortalama RKS, tedavinin ikinci saatinden itibaren HF grubunun lehine farklılık gösterdi (p=0,002). Sadece S grubunda hastaların %17,1’inde beklenen iyileşme görülmedi ve HF eklenmesi gerekti. HF grubundaki hastalar ve S’ye HF eklenen hastalarda daha yüksek hastane yatış oranları (p=0,017), daha uzun hastanede kalış süreleri (p=0,002) ve daha uzun oksijen tedavisi süreleri (p=0,001) vardı. Taburcu olduktan sonra PED’ye tekrar başvuru sadece S grubunda %64,2 oranında görüldü (p<0,001).
Sonuç
Bu çalışmada; HFNC tedavisinin bronşiyolitli çocuklarda daha erken ve daha hızlı klinik iyileşme sağladığı ve aynı hastalığa bağlı tekrar yatışları azalttığı söylenebilir.
Anahtar Kelimeler:
Akut bronşiolit, salbutamol, yüksek akımlı nazal oksijen tedavisi
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