Abstract
Bronchiolitis is a common viral lower respiratory tract infection in children under two years of age. It is associated with high morbidity, frequent hospitalizations, and increased healthcare costs, although mortality remains low. Aim:To identify clinical predictors of Pediatric Intensive Care Unit (PICU) admission among children diagnosed with bronchiolitis. Methods: A retrospective review was conducted of all pediatric files with a diagnosis of bronchiolitis at Jala Children’s Hospital, Tripoli, Libya, between 1 October 2018 and 31 March 2019. Data were collected using a structured questionnaire, including demographic, clinical, and laboratory variables. Children admitted to the general pediatric ward were compared with those admitted to the PICU. Results: Ninety children met the inclusion criteria. The median age was 62.5 days (IQR 45–120), and 62.2% were male. Of these, 60% were admitted to the regular ward, while 40% required PICU care. Significant predictors of PICU admission included formula feeding (72.2% vs. 22.2%; p = 0.015), higher respiratory rate (65.5 ± 6.78 vs. 53.5 ± 7.75 breaths/min; p < 0.001), and lower room-air oxygen saturation (86.6 ± 5.98 vs. 93.1 ± 3.71; p = 0.012). Other factors—such as age, sex, family history of asthma, eczema, birth weight, heart rate, and chest X-ray findings—were not significantly associated with PICU admission. Conclusion: Formula feeding, elevated respiratory rate, and decreased oxygen saturation were key predictors of PICU admission in children with bronchiolitis. These findings emphasize the need to develop standardized guidelines and protocols for PICU admission in the hospital’s emergency department