Background: Bronchiolitis is the most common viral infection of the lower respiratory tract in infants under 2 years of age. The aim of this study was to analyze and compare the seasonal bronchiolitis peaks before and during the SARS-CoV-2 pandemic. Methods: Descriptive, prospective, and observational study. Patients with severe bronchiolitis admitted to the Pediatric Intensive Care Unit (PICU) of a referral tertiary hospital between September 2010 and June 2021 were included. Demographic data were collected. Viral laboratory-confirmation was carried out. Each season was analyzed and compared. The daily average temperature was collected. Results: 1116 patients were recruited, 58.2% of them males. The median age was 49 days. Respiratory syncytial virus (RSV) was isolated in 782 cases (70.1%). In April 2021, the first and only case of bronchiolitis caused by SARS-CoV-2 was identified. The pre- and post-pandemic periods were compared. There were statistically significant differences regarding: age, 47 vs. 73 days (p = 0.006), PICU and hospital length of stay (p = 0.024 and p = 0.001, respectively), and etiology (p = 0.031). The peak for bronchiolitis in 2020 was non-existent before week 52. A delayed peak was seen around week 26/2021. The mean temperature during the epidemic peak was 10ºC for the years of the last decade and is 23ºC for the present season. Conclusion: The COVID-19 pandemic outbreak has led to a clearly observable epidemiological change regarding acute bronchiolitis, which should be studied in detail. The influence of the environmental temperature does not seem to determine the viral circulation.

Aim: Adapting “escape rooms” for educational purposes is an innovative teaching method. The aim of this study was to ascertain the degree of learning of the residents. A secondary objective was to determine their degree of satisfaction. Methods: A prospective, observational study took place in October 2019. A sepsis-based escape room was designed and carried out. A mix of paediatric medical residents and paediatric nursing residents were enrolled. A prior knowledge test was carried out, which was repeated right at the end of the escape room and then again three months later. Furthermore, all participants completed an anonymous post-study survey. Results: We enrolled 48 residents, 79.2% of whom were women. The mean score for the pre-escape room exam was 7.85/9 (SD 1.65), that for the post-escape room exam was 8.75/9 (SD 0.53), and for the exam three months later, it was 8.30/9 (SD 0.94). Among the participants, 18.8% did not manage to leave before the established 60 min time limit. The results of the satisfaction survey showed high participant satisfaction. Conclusions: The escape room proved to be a valuable educational game that increased students’ knowledge of sepsis management and showed a positive overall perceived value among the participants.

The transport of critically ill pediatric patients is associated with the occurrence of adverse events (AE) and incidents that worsen patient outcomes. The primary objective was to determine the AEs and incidents that occurred during interhospital transport and to analyze changes after the implementation of safety measures. The secondary objective was to analyze the association between the presence of family accompanying the patient in the ambulance and the number of incidents. Prospective and observational study, including patients transferred by a specialized pediatric transport team during two periods: period 1 (2017-2018) and period 2 (2022-2023). We compared incidents in the two periods after the implementation of safety measures. We also compared the presence of parents during the transport and its association with the occurrence of incidents. We analyzed 1369 transports. A total of 273 (20.7%) patients experienced some incident during transport, with a lower percentage in period 2 (29.2% vs 12.0%; P < .001), especially in patients with clinical incidents (20.3% vs 5.1%; P < .001). Incidents involving a lack of devices or supplies were least frequent, with no differences between the two periods. Family accompanied the patient in the ambulance more frequently in the second period (76.0% vs 82.6%; P = .001), a finding that was not associated with an increase in incidents, with a higher percentage of transports with parents in the care cabin. Interhospital pediatric transport performed by teams trained in clinical safety leads to few incidents. Implementing measures to improve patient safety can reduce the frequency of these incidents and optimize care quality.

Purpose: Respiratory syncytial virus-positive bronchiolitis continues to be the main diagnosis prompting transportation in children younger than one year of age. It represents approximately 15–20% of all services performed by a specialized pediatric transport team. In October 2023, an immunization program with nirsevimab, a monoclonal antibody against RSV, was started in Spain. The purpose of the present study is to describe how nirsevimab affects the rates of bronchiolitis managed by a pediatric team specialized in critical patient transport. Secondary objectives included describing and comparing the clinical aspects of the two cohorts—pre-nirsevimab (pre-n) and post-nirsevimab (post-n)—to quantify how immunization has modified the clinical phenotype of bronchiolitis. Methods: This is a descriptive and observational study. Patients with bronchiolitis transported by a specialized pediatric transport team between September 2021 and August 2025 were included. Demographic, clinical, and microbiological data were collected. The pre-n and post-n periods were compared. Results: From a total of 2347 interfacility transports conducted by the unit between 2021 and 2025, 463 (19.7%) involved bronchiolitis patients, all of whom were recruited: 307 in the pre-n period and 156 in the post-n. The median age was 2.5 months (IQR 1.3–5.7), and 55% were male. There was a significant decrease in bronchiolitis cases that required specialized transport between the two periods: 28.2% (307/1089) pre-n vs. 12.4% (156/1258) post-n (p < 0.001). RSV detection also declined (74.3% vs. 47.4%, p < 0.001), while other viruses increased significantly in the post-n period, including rhinovirus, metapneumovirus and bocavirus. Age at admission showed statistically significant differences across the two periods (2.2 vs. 3.4 months, p < 0.001). There were no differences in severity between the two periods in terms of respiratory and inotropic support and length of stay. No mortality was reported. Conclusions: Universal nirsevimab immunization was associated with a marked reduction in pediatric transports for bronchiolitis, particularly RSV-related cases, without modifying disease severity among those requiring transfer.

Introduction. Bronchiolitis is the leading cause of Pediatric Intensive Care Unit (PICU) admission for lower respiratory tract infection in infants. Although survival has improved, concerns remain regarding potential long-term functional impairments, including alterations in psychomotor development, learning, and behavior. This study aimed to describe the epidemiological and clinical characteristics of children admitted to the PICU for bronchiolitis and to evaluate their functional outcomes at 12-month follow-up. Methods. A retrospective descriptive cohort study was conducted, including all patients admitted to the PICU for bronchiolitis during the 2021–2022 period. Epidemiological, clinical, microbiological, and laboratory data were collected. Functional health status was assessed using the Pediatric Overall Performance Category (POPC), Pediatric Cerebral Performance Category (PCPC), and Functional Status Scale (FSS) at PICU discharge and 12 months. Changes in functional status were categorized as improved, stable, or worsened. Exploratory unadjusted analyses were performed to describe differences between outcome groups. Results. A total of 164 patients were included (43.9% female), with a median age of 51 days (IQR 26.25–118.5). Respiratory syncytial virus was identified in 79.7% of cases. Invasive mechanical ventilation was required in 31.1% of patients, and 45.7% developed complications during PICU admission. Mortality was 0.6%. At 12 months, functional deterioration was observed in 14.6% of patients according to POPC, 16.5% according to PCPC, and 3.6% according to FSS. Higher proportions of functional deterioration were observed among patients with underlying medical conditions, those requiring invasive mechanical ventilation, those with complications, and those with longer PICU and hospital stays, particularly in the PCPC scale. Conclusions. Most children admitted to the PICU for bronchiolitis showed stable or improved functional status at 12 months. However, a subset experienced functional deterioration, more frequently observed in patients with greater clinical severity and complexity during admission. These results support the need for further studies to better characterize long-term outcomes and to identify children who may benefit from closer follow-up.