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Medtronic / PM&RI | Your Acute Care – Critical Care Medtech Partner / Rise of Bronchiolitis

How to prepare your hospital against bronchiolitis in neonates.

How can you prepare your hospital to take care of your youngest patients?

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Bronchiolitis in infants and children

After the devastating ravage that spread across the world and the strain the healthcare system has been put under due to COVID-19 the past 3 years, this year the notorious virus is not alone and has company. Common seasonal viruses such a bronchiolitis and strong flus which lay low for the last two winters, have aggressively made a comeback.1 This winter season, bronchiolitis has been the leading cause of infant and children hospitalization.2

Bronchiolitis is an acute lower respiratory tract infection, caused primarily by viruses, which affects the small airways in the lungs.2

A concern during tripledemic.

In recent years, the incidence of bronchiolitis has been steadily increasing, leading to an increase in the number of hospitalizations and deaths associated with the condition.3 Bronchiolitis is caused by a variety of viruses, including respiratory syncytial virus (RSV), adenoviruses, and parainfluenza viruses.4 RSV is the most common cause of bronchiolitis, especially in infants and young children.4 The virus is highly contagious and easily spread through contact with an infected person or object. 4

The symptoms of bronchiolitis typically include a runny and stuffy nose, cough, difficulty breathing, and slight fever. In severe cases, an infant or child may experience wheezing, breathing very fast — more than 60 breaths a minute (tachypnea) — poor feeding or skin turning blue.4 The condition can be more serious in infants, as their airways are much smaller and can become easily blocked.5

 

Facing the challenge of bronchiolitis during the tripledemic is stressful. Contact us today and our reps are standing by to speak with you and provide all the details you need. 
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How can you prepare your hospital to take care of your youngest patients?

It all starts with a proper diagnosis

For infants and children, pulse oximetry monitoring is an effective tool that helps you assess the severity grade of bronchiolitis and guide the treatment pathway, while offering accurate and reliable reading during supplemental O2 therapy.6

Introducing Nellcor’s new sensor that is designed for infants. 

The skin of infants is much more fragile than that of adults, making it difficult to place a pulse oximetry sensor without tearing or damaging their epidermis and causing them extreme stress.7

Our Nellcor™OxySoft™ SpO2 sensor is the first pulse oximetry sensor to use a silicone adhesive to protect fragile skin, withstands up to 18 repositions without losing its adhesiveness and because of that reduces waste.8,9

Additionally, OxySoft™ is designed to improve signal acquisition during low perfusion and patient movement.10

SatSeconds offering the solution to alarm fatigue

Alarm fatigue is a growing problem in healthcare, with studies showing that healthcare professionals are becoming desensitized to alarms due to the sheer number of false alarms they are receiving. An estimated 85% to 99% of alarms in healthcare don’t require clinical intervention.11,12 False alarms are created when the pulse oximetry device detects a saturation level that is below normal, but is not indicative of a medical emergency. As a result, healthcare professionals are often left to determine whether an alarm is a false one or a true medical emergency.11

The Nellcor™ SatSeconds feature filters out the very short dips in SpO2 which may help reduce nuisance alarms by up to 40% in neonates and minimize alarm fatigue. If SpO2 drops below the alarm threshold for a longer period, the alarm will sound. So, you know the alarm is significant.13,14

Interested in our latest Nellcor™ technology? Contact us and we will reach out to you as soon as possible. 

The ventilation support your neonate patient needs

Upgrade your Puritan Bennett™ 980 ventilators† with software to help enhance neonatal lung protection. Here are four ways the software may help:

1. Enhance patient care and comfort.

The high flow oxygen therapy (HFO2T) software option for the Puritan Bennett™ 980 ventilator delivers oxygen at higher flow rates than traditional oxygen therapy to help improve oxygenation.15 Once the patient is set up, the HFO2T screen displays only the flow and O2 parameters ― allowing you to focus on the most relevant information. 

2. Provide safe ventilatory support.

The Puritan Bennett™ NeoMode 2.0 software option was developed for neonates to address the issues most critical to their care and safety, such as accurate breath delivery, responsive triggering, lower elevated oxygen preset for procedures, effective alarm management, and automatic leak compensation.16 Neomode also helps you deliver effective noninvasive ventilation, including the use of SIMV (Snychronized Intermittent Mandatory Ventilation) and CPAP (Continous Positive Airway Pressure).16

3. Monitor every breath.

NIV+ software for the Puritan Bennett™ 980 ventilator‡ is designed to measure end inspiratory and end expiratory pressures at the patient interface.17 This provides valuable information to the clinician and may reduce the uncertainty around effective pressure and PEEP delivery to the patient. It also provides a robust means of determining disconnect, especially when leaks are present.17,18

Contact us and discover the best option for your hospital.

We are here to help you prepare for respiratory threats through the remainder of the season and beyond. If you’re interested in upgrading your ventilators and pulse oximetry technologies, please reach out with any questions.

Contact us
Related resources
Bronchiolitis brochure
View brochure
References

† Please pay close attention to warnings and their associated consequences as described in the Puritan Bennett™ 980 ventilator operator’s manual. The ventilator system is not intended to be a comprehensive monitoring device and does not activate alarms for all types of conditions. Do not operate the ventilator in a magnetic resonance imaging (MRI) environment. Risks associated with using a mechanical ventilator include but are not limited to hypoxemia, hypercarbia, hypocarbia, and infection. 

‡ The NIV+ software option works in conjunction with the NeoMode 2.0 software option. 

1. Anthes, E. (2022, December 22). 'tripledemic' rages on: Fever-filled weeks lie ahead. The New York Times. Retrieved January 23, 2023, from https://www.nytimes.com/2022/12/22/health/covid-flu-rsv-winter-surge.html

2. Loconsole D, Centrone F, Rizzo C, et al. Out-of-Season Epidemic of Respiratory Syncytial Virus during the COVID-19 Pandemic: The High Burden of Child Hospitalization in an Academic Hospital in Southern Italy in 2021. Children (Basel). 2022;9(6):848. Published 2022 Jun 8.

3. Noble M, Khan RA, Walker B, Bennett E, Gent N. Respiratory syncytial virus-associated hospitalisation in children aged ≤5 years: a scoping review of literature from 2009 to 2021. ERJ Open Res. 2022;8(2):00593-2021. Published 2022 May 30.

4. Mayo Foundation for Medical Education and Research. (2020, January 15). Bronchiolitis. Mayo Clinic. Retrieved January 19, 2023, from https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565 https://www.mayoclinic.org/diseases-conditions/bronchiolitis/symptoms-causes/syc-20351565

5. Hirsch, L. (Ed.). (2022, October). Bronchiolitis - nemours kidshealth. KidsHealth. Retrieved January 24, 2023, from https://kidshealth.org/en/parents/bronchiolitis.html

6. Mahant S, Wahi G, Bayliss A, et al. Intermittent vs Continuous Pulse Oximetry in Hospitalized Infants With Stabilized Bronchiolitis: A Randomized Clinical Trial. JAMA Pediatr. 2021;175(5):466–474. doi:10.1001/jamapediatrics.2020.6141 https://jamanetwork.com/journals/jamapediatrics/article-abstract/2776775

7. Villarroel M, Guazzi A, Jorge J, et al. Continuous non-contact vital sign monitoring in neonatal intensive care unit. Healthc Technol Lett. 2014;1(3):87-91. Published 2014 Sep 23. doi:10.1049/htl.2014.0077

8. Nellcor Oxysoft Patent AD N°A0003070US01

9. Nellcor Oxysoft Research Reports: CSR s20_12 Gentleness Report, CSR s20_14 Reapplication Report

10. Nellcor Oxysoft Report RE00368468

11. Graham KC, Cvach M. Monitor alarm fatigue: standardizing use of physiological monitors and decreasing nuisance alarms. Am J Crit Care. 2010;19(1):28-35.

12.  The Joint Commission. Medical device alarm safety in hospitals. Sentinel Event Alert. April 8, 2013; issue 50. Available at: http://www.jointcommission.org/assets/1/18/SEA_50_alarms_4_5_13_FINAL1.PDF

13. Brostowicz, Heather M. and Rais-Bahrami, K. ‘Oxygen Saturation Monitoring in the Neonatal Intensive Care Unit (NICU): Evaluation of a New Alarm Management’. 1 Jan. 2010 : 135 – 139.

14. Stefanescu BM, O'Shea TM, Haury F, Carlo WA, Slaughter JC. Improved Filtering of Pulse Oximeter Monitoring Alarms in the Neonatal ICU: Bedside Significance. Respir Care. 2016;61(1):85-89. doi:10.4187/respcare.04177

15. Biselli PJ, Kirkness JP, Grote L, et al. Nasal high-flow therapy reduces work of breathing compared with oxygen during sleep in COPD and smoking controls: a prospective observational study. J Appl Physiol (1985). 2017;122(1):82-88.

16.  PuritanBennet980 Operators Manual N° PT00128079A00/2020

17.  PuritanBennet980 NIV+ Software Option Operator's Manual N° PT00105008/2020

18.  Itagaki T, Chenelle CT, Bennett DJ, Fisher DF, Kacmarek RM. Effects of Leak Compensation on Patient-Ventilator Synchrony During Premature/Neonatal Invasive and Noninvasive Ventilation: A Lung Model Study. Respir Care. 2017;62(1):22-33.