Young infants with bronchiolitis at low risk of respiratory deterioration in an urban, academic emergency department: prospective cohort study protocol.

Journal: BMJ open
Published Date: Aug 26, 2025

Abstract

INTRODUCTION: Bronchiolitis, a viral lower respiratory tract infection, is the leading cause of hospitalisation for infants, with healthcare utilisation highest among young infants (aged ≤90 days). Clinical models to predict respiratory deterioration in infants with bronchiolitis have been developed for a broad age group that includes children up to 2 years old, not focusing specifically on young infants. These models have also been limited by exclusion of viral aetiology and by use of vital signs measured at a single time point during clinical evaluation, overlooking the variable and dynamic course of bronchiolitis. This study aims to combine clinical history and examination factors with viral aetiology (primary aim) and continuous physiological data from bedside monitors (secondary aim) to develop accurate prediction models to identify young infants at low risk of respiratory deterioration and enable safe discharge to home.

Authors

  • Son H McLaren
    New York Presbyterian Hospital/Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065 USA.
  • Carlos A Camargo
    Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.
  • Todd A Florin
    Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine (S Ramgopal, TA Florin, ER Alpern, and ML Macy), Chicago, Ill.
  • Cheng-Shiun Leu
    Department of Biostatistics, Columbia University, New York, NY, USA.
  • Asuncion Mejias
    Infectious Diseases, St Jude Children's Research Hospital, Memphis, Tennessee, USA.
  • Jiying Han
    Biostatistics, Columbia University Mailman School of Public Health, New York, New York, USA.
  • Murad Megjhani
    Department of Neurology, Columbia University, New York, NY, USA.
  • Joseph R Isler
    Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
  • Rakesh Sahni
    Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
  • Tammam Alalqum
    Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
  • Daniel A Green
    Pathology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
  • Daniel Fenster
    Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
  • Marlin V Morel
    Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
  • Tania Pakholok
    Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
  • Vanessa Lorenzo
    Pediatric Emergency Department, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
  • Soojin Park
    Department of Neurology, Department of Biomedical Informatics, Columbia University, New York, NY, USA.
  • Peter S Dayan
    Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.

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