Bronchiolitis: Recent Evidence on Diagnosis and Management

  title={Bronchiolitis: Recent Evidence on Diagnosis and Management},
  author={Joseph J. Zorc and Caroline Breese Hall},
  pages={342 - 349}
Viral bronchiolitis is a leading cause of acute illness and hospitalization of young children. Research into the variation in treatment and outcomes for bronchiolitis across different settings has led to evidence-based clinical practice guidelines. Ongoing investigation continues to expand this body of evidence. Authors of recent surveillance studies have defined the presence of coinfections with multiple viruses in some cases of bronchiolitis. Underlying comorbidities and young age remain the… 

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Recent evidence on the management of bronchiolitis

Much of the emphasis of the last few decades of bronchiolitis clinical care and research has centered on the identification and testing of novel therapies, with increasing recognition of viruses other than respiratory syncytial virus and better awareness of the role of viral coinfections.

Bronchiolitis: the recent evidence.

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The available data is yet largely against the routine use of bronchodilators or corticosteroids, though a combination of these two looks promising future trend and the role of nebulized hypertonic saline in bronchiolitis is getting a wider acceptance and is likely to get established a part of routine care.

Recent advances in management of bronchiolitis

Evaluating the evidence supporting the use of currently available treatment and preventive strategies for infants with bronchiolitis and to provide practical guidelines to the practitioners managing children with bronChiolitis found supportive care, comprising of taking care of oxygenation and hydration, remains the corner-stone of therapy in bron chiolitis.

Management of acute viral bronchiolitis in children: Evidence beyond guidelines.

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The key to reducing the morbidity and mortality in children with RSV bronchiolitis is through prevention of infection through immunoprophylaxis especially in high-risk children.

Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age.

Groups at high risk for severe disease are described and guidelines for admission to hospital are presented, and evidence for the efficacy of various therapies is discussed and recommendations are made for management.

Acute bronchiolitis: assessment and management in the emergency department.

While studies have demonstrated a lack of efficacy for bronchodilators and corticosteroids, more recent studies suggest a potential role for combination therapies and high-flow nasal cannula therapy.

Current Concepts in the Evaluation and Management of Bronchiolitis.

Treatment of Acute Viral Bronchiolitis

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Most children with bronchiolitis have a self limiting mild disease and can be safely managed at home with careful attention to feeding and respiratory status, and there is confusion and lack of evidence over the best treatment for this condition.



Diagnosis and Management of Bronchiolitis

This guideline addresses the diagnosis of bronchiolitis as well as various therapeutic interventions including bronchodilators, corticosteroids, antiviral and antibacterial agents, hydration, chest physiotherapy, and oxygen.

Diagnosis and management of bronchiolitis.

This guideline addresses the diagnosis of bronchiolitis as well as various therapeutic interventions including bronchodilators, corticosteroids, antiviral and antibacterial agents, hydration, chest physiotherapy, and oxygen.

Diagnosis and testing in bronchiolitis: a systematic review.

Reviewing systematically the data on diagnostic and supportive testing in the management of bronchiolitis to assess the utility of such testing and finding no data show that respiratory syncytial virus testing affects clinical outcomes in typical cases of the disease.

A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis.

In infants with acute moderate-to-severe bronchiolitis who were treated in the emergency department, a single dose of 1 mg of oral dexamethasone per kilogram did not significantly alter the rate of hospital admission, the respiratory status after 4 hours of observation, or later outcomes.

Clinical predictors of the severity of bronchiolitis

Oxygen saturation less than 95%, respiratory frequency more than 45 breaths per minute and age less than 6 months in respiratory-distressed infants are important parameters to predict the need for admission and emphasize the severity of bronchiolitis.

Bronchiolitis: Lingering Questions About Its Definition and the Potential Role of Vitamin D

The increasing disease burden of bronchiolitis from 1996 to 2003 in healthy, term infants enrolled in the Tennessee Medicaid program is described and raises important questions not only about the definition of bronChiolitis but also about the reason for the increasing number of medical visits.

Evaluation of an evidence-based guideline for bronchiolitis.

An evidence-based clinical practice guideline for managing bronchiolitis was highly successful in modifying care during its first year of implementation at Children's Hospital Medical Center in Cincinnati, Ohio.

Office-Based Treatment and Outcomes for Febrile Infants With Clinically Diagnosed Bronchiolitis

In office settings, serious bacterial illness in young febrile infants with clinically diagnosed bronchiolitis is uncommon and limited testing for bacterial infections seems to be an appropriate management strategy.

Epinephrine for bronchiolitis.

There is insufficient evidence to support the use of epinephrine for the treatment of bronchiolitis among inpatients, and there is some evidence to suggest thatEpinephrine may be favourable to salbutamol and placebo among outpatients.

Outpatient assessment of infants with bronchiolitis.

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