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Bronchiolitis is a common viral illness. It is most commonly caused by respiratory syncytial virus and typically occurs over the late fall and winter months. Children less than 2 years of age are most commonly affected, with the largest burden of illness being in children less than 12 months of age.

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Key studies English (24) French All (24)

Key Study: Association of Fluid Overload with Clinical Outcomes in Critically Ill Children with Bronchiolitis: Bronquiolitis en la Unidad de Cuidados Intensivos Pediatricos (BRUCIP) Study*

Visit

Flores-Gonzalez, J. C. V., C. M.; Yun Castilla, C.; Mayordomo-Colunga, J.; Qu...

Objective: To our knowledge, few studies have examined the impact of fluid balance on clinical outcome in severe bronchiolitis. Our aim was to determine whether fluid overload was associated with adverse clinical outcomes in critically ill children with severe bronchiolitis.

Key Study: [Does heliox administered by low-flow nasal cannula improve respiratory distress in infants with respiratory syncytial virus acute bronchiolitis? A randomized controlled trial]

Visit

Seliem, W and Sultan, AM

Objective: To evaluate whether the use of heliox (79:21) delivered through a low flow nasal cannula would improve respiratory distress in infants with acute bronchiolitis caused by respiratory syncytial virus.

Key Study: Chest radiography in children hospitalized with bronchiolitis

Visit

Wrotek A, Czajkowska M, Jackowska T

Objective: to evaluate the use of CR in children with bronchiolitis due to a lower respiratory tract infection (RSV-RTI) with respiratory syncytial virus (RSV) and the influence of CR on patient treatment during the 2010-2017 seasons.

Key Study: A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis

Visit

Franklin, D. B., F. E.; Schlapbach, L. J.; Oakley, E.; Craig, S.; Neutze, J.;...

Objective: To assess efficacy of high-flow oxygen therapy through a nasal cannula in settings other than intensive care units (ICUs).

Key Study: Heliox delivered by high flow nasal cannula improves oxygenation in infants with respiratory syncytial virus acute bronchiolitis

Visit

Seliem, W. S., A. M.

Objective: to evaluate the hypothesis that use of heliox would result in improvement of gas exchange when used with high flow nasal cannula in infants with RSV acute bronchiolitis.

Key Study: Predicting escalated care in infants with bronchiolitis

Visit

Freire

Objective: to identify predictors of "escalated care" in bronchiolitis.

Key Study: Predictors of critical care and mortality in bronchiolitis after emergency department discharge

Visit

Schuh S, Kwong J, Holder L, Graves E, Macdonald E, Finkelstein Y

Objectives:To identify the epidemiologic predictors and stratify the risk of critical care unit (CCU) admission or death in bronchiolitis following emergency department discharge. This information has not yet been explored.

Key Study: Lung ultrasound for the diagnosis of pneumonia in children with acute bronchiolitis

Visit

Biagi C, Pierantoni L, Baldazzi M, Greco L, Dormi A, Dondi A, Faldella G, Lan...

Objective: to assess the diagnostic accuracy and reliability of LUS for the detection of pneumonia in hospitalized children with bronchiolitis and to evaluate the agreement between LUS and CXR in diagnosing pneumonia in these patients.

Key Study: High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): An open, phase 4, randomised controlled trial

Visit

Kepreotes E, Whitehead B, Attia J, Oldmeadow C, Collison A, Searles A, Goddar...

Objectives: Bronchiolitis is the most common lung infection in infants and treatment focuses on management of respiratory distress and hypoxia. High-flow warm humidified oxygen (HFWHO) is increasingly used, but has not been rigorously studied in randomised trials. This study aimed to examine whether HFWHO provided enhanced respiratory support, thereby shortening time to weaning off oxygen

Key Study: Effect of nebulized hypertonic saline treatment in emergenc departments on hospitalization rate for acute bronchiolitis: a randomized clinical trial

Visit

Angoulvant F, Belletre X, Milcent K, et al

Objective: To examine whether HS nebulization treatment would decrease the hospital admission rate among infants with a first episode of acute bronchiolitis.

Key Study: High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study)

Visit

Milsi C, Essouri S, Pouyau R, Liet JM, Afanetti M, Portefaix A, Baleine J,Dur...

Objective: To assess oxygen delivery via high flow nasal cannula (HFNC).

Key Study: Effect of oxygen desaturations on subsequent medical visits in infants discharged from the emergency department with bronchiolitis

Visit

Principi T, Coates AL, Parkin PC, Stephens D, DaSilva Z, Schuh S

Objective: To examine whether there is a difference in the proportion of unscheduled medical visits within 72 hours of emergency department discharge in infants with bronchiolitis who have oxygen desaturations to lower than 90% for at least 1 minute during home oximetry monitoring vs those without desaturations.

Key Study: Nasal irrigation with saline solution significantly improves oxygen saturation in infants with bronchiolitis

Visit

Schreiber S, Ronfani L, Ghirardo S, Minen F, Taddio A, Jaber M, Rizzello E, B...

Objective: To compare nasal irrigation using either isotonic 0.9% sodium chloride or hypertonic 3% sodium chloride with simple supportive care in infants with bronchiolitis.

Key Study: Use of intermittent vs continuous pulse oximetry for nonhypoxemic infants and young children hospitalized for bronchiolitis: a randomized controlled trial

Visit

McCulloh R, Koster M, Ralston S, Johnson M, Hill V, Koehn K, Weddle G, Alvers...

Objective: To determine the effect of intermittent vs continuous pulse oximetry monitoring on hospital length of stay among nonhypoxemic infants and young children hospitalized for bronchiolitis.

Key Study: Epinephrine Improves the Efficacy of Nebulized Hypertonic Saline in Moderate Bronchiolitis: A Randomised Clinical Trial

Visit

Flores-Gonzlez JC, Matamala-Morillo MA, Rodrguez-Campoy P, Prez-Guerrero JJ, ...

Objective: To evaluate the efficacy of nebulized epinephrine in 3% hypertonic saline.

Key Study: Bronchiolitis of Infancy Discharge Study (BIDS): a multicentre, parallel-group, double-blind, randomised controlled, equivalence trial with economic evaluation

Visit

Cunningham S, Rodriguez A, Boyd KA, McIntosh E, Lewis SC, BIDS Collaborators ...

Objective: To compare the American Academy of Pediatrics guideline target of SpO2 90% with the Scottish Intercollegiate Guidelines Network target of SpO2 94%.

Key Study: Nebulised hypertonic saline (3%) among children with mild to moderately severe bronchiolitis--a double blind randomized controlled trial

Visit

Khanal A, Sharma A, Basnet S, Sharma PR, Gami FC

Objective: To Assess the efficacy of nebulised hypertonic saline (HS) (3%) among children with mild to moderately severe bronchiolitis.

Key Study: Effect of oximetry on hospitalization in bronchiolitis: a randomized clinical trial

Visit

Schuh S, Freedman S, Coates A, Allen U, Parkin P, Stephens D, Ungar W, DaSilv...

Objective: To examine if infants with bronchiolitis whose displayed oximetry measurements have been artificially elevated 3 percentage points above true values experience hospitalization rates at least 15% lower compared with infants with true values displayed.

Key Study: Nasogastric hydration vs intravenous hydration for infants with bronchiolitis: a randomised trial

Visit

Oakley Ed, Borland M, () Babl F

Objective: to assess whether intravenous hydration or nasogastric hydration is better for treatment of infants.

Key Study: Epinephrine and dexamethasone in children with bronchiolitis

Visit

Plint AC, Johnson DW, Patel H, Wiebe N, Correll R, Brant R, Mitton C, Gouin S...

This randomized, double-blind, placebo-controlled, clinical trial with a factorial design at multiple sites was undertaken to determine whether treatment with nebulized epinephrine, a short course of oral dexamethasone, or both resulted in a clinically important decrease in hospital admissions among infants with bronchiolitis who were seen in the emergency department.

Key Study: A cost-effectiveness analysis of omitting radiography in diagnosis of acute bronchiolitis

Visit

Yong JHE, Schuh S, Rashidi R, Vanderby S, Lau R, Laporte A, Nauenberg E, Unga...

Objective:To carry out a cost-effectiveness analysis of omitting chest radiography in the diagnosis of infant bronchiolitis.

Key Study: A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis

Visit

Corneli HM, Zorc JJ, Mahajan P, Shaw KN, Holubkov R, Reeves SD, Ruddy RM, Mal...

The goal of this study was to determine the effectiveness of a single dose of oral dexamethasone in infants with moderate-to-severe bronchiolitis.

Key Study: Evaluation of the utility of radiography in acute bronchiolitis

Visit

Schuh S, Lalani A, Allen U, Manson D, Babyn P, Stephens D, MacPhee S, Mokansk...

Objectives: to determine the proportion of radiographs inconsistent with bronchiolitis in children with typical presentation of bronchiolitis and to compare rates of intended antibiotic therapy before radiography versus those given antibiotics after radiography.

Key Study: Risk of serious bacterial infection in young febrile infants with respiratory syncytial virus infections

Visit

Levine DA, Platt SL, Dayan PS, Macias CG, Zorc JJ, Krief W, Schor J, Bank D, ...

Objective: to determine the risk of SBI in young febrile infants who are infected with RSV compared with those without RSV infections.

Key Study: Association of Fluid Overload with Clinical Outcomes in Critically Ill Children with Bronchiolitis: Bronquiolitis en la Unidad de Cuidados Intensivos Pediatricos (BRUCIP) Study*

Visit

Flores-Gonzalez, J. C. V., C. M.; Yun Castilla, C.; Mayordomo-Colunga, J.; Qu...

Objective: To our knowledge, few studies have examined the impact of fluid balance on clinical outcome in severe bronchiolitis. Our aim was to determine whether fluid overload was associated with adverse clinical outcomes in critically ill children with severe bronchiolitis.

Key Study: [Does heliox administered by low-flow nasal cannula improve respiratory distress in infants with respiratory syncytial virus acute bronchiolitis? A randomized controlled trial]

Visit

Seliem, W and Sultan, AM

Objective: To evaluate whether the use of heliox (79:21) delivered through a low flow nasal cannula would improve respiratory distress in infants with acute bronchiolitis caused by respiratory syncytial virus.

Key Study: Chest radiography in children hospitalized with bronchiolitis

Visit

Wrotek A, Czajkowska M, Jackowska T

Objective: to evaluate the use of CR in children with bronchiolitis due to a lower respiratory tract infection (RSV-RTI) with respiratory syncytial virus (RSV) and the influence of CR on patient treatment during the 2010-2017 seasons.

Key Study: A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis

Visit

Franklin, D. B., F. E.; Schlapbach, L. J.; Oakley, E.; Craig, S.; Neutze, J.;...

Objective: To assess efficacy of high-flow oxygen therapy through a nasal cannula in settings other than intensive care units (ICUs).

Key Study: Heliox delivered by high flow nasal cannula improves oxygenation in infants with respiratory syncytial virus acute bronchiolitis

Visit

Seliem, W. S., A. M.

Objective: to evaluate the hypothesis that use of heliox would result in improvement of gas exchange when used with high flow nasal cannula in infants with RSV acute bronchiolitis.

Key Study: Predicting escalated care in infants with bronchiolitis

Visit

Freire

Objective: to identify predictors of "escalated care" in bronchiolitis.

Key Study: Predictors of critical care and mortality in bronchiolitis after emergency department discharge

Visit

Schuh S, Kwong J, Holder L, Graves E, Macdonald E, Finkelstein Y

Objectives:To identify the epidemiologic predictors and stratify the risk of critical care unit (CCU) admission or death in bronchiolitis following emergency department discharge. This information has not yet been explored.

Key Study: Lung ultrasound for the diagnosis of pneumonia in children with acute bronchiolitis

Visit

Biagi C, Pierantoni L, Baldazzi M, Greco L, Dormi A, Dondi A, Faldella G, Lan...

Objective: to assess the diagnostic accuracy and reliability of LUS for the detection of pneumonia in hospitalized children with bronchiolitis and to evaluate the agreement between LUS and CXR in diagnosing pneumonia in these patients.

Key Study: High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): An open, phase 4, randomised controlled trial

Visit

Kepreotes E, Whitehead B, Attia J, Oldmeadow C, Collison A, Searles A, Goddar...

Objectives: Bronchiolitis is the most common lung infection in infants and treatment focuses on management of respiratory distress and hypoxia. High-flow warm humidified oxygen (HFWHO) is increasingly used, but has not been rigorously studied in randomised trials. This study aimed to examine whether HFWHO provided enhanced respiratory support, thereby shortening time to weaning off oxygen

Key Study: Effect of nebulized hypertonic saline treatment in emergenc departments on hospitalization rate for acute bronchiolitis: a randomized clinical trial

Visit

Angoulvant F, Belletre X, Milcent K, et al

Objective: To examine whether HS nebulization treatment would decrease the hospital admission rate among infants with a first episode of acute bronchiolitis.

Key Study: High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study)

Visit

Milsi C, Essouri S, Pouyau R, Liet JM, Afanetti M, Portefaix A, Baleine J,Dur...

Objective: To assess oxygen delivery via high flow nasal cannula (HFNC).

Key Study: Effect of oxygen desaturations on subsequent medical visits in infants discharged from the emergency department with bronchiolitis

Visit

Principi T, Coates AL, Parkin PC, Stephens D, DaSilva Z, Schuh S

Objective: To examine whether there is a difference in the proportion of unscheduled medical visits within 72 hours of emergency department discharge in infants with bronchiolitis who have oxygen desaturations to lower than 90% for at least 1 minute during home oximetry monitoring vs those without desaturations.

Key Study: Nasal irrigation with saline solution significantly improves oxygen saturation in infants with bronchiolitis

Visit

Schreiber S, Ronfani L, Ghirardo S, Minen F, Taddio A, Jaber M, Rizzello E, B...

Objective: To compare nasal irrigation using either isotonic 0.9% sodium chloride or hypertonic 3% sodium chloride with simple supportive care in infants with bronchiolitis.

Key Study: Use of intermittent vs continuous pulse oximetry for nonhypoxemic infants and young children hospitalized for bronchiolitis: a randomized controlled trial

Visit

McCulloh R, Koster M, Ralston S, Johnson M, Hill V, Koehn K, Weddle G, Alvers...

Objective: To determine the effect of intermittent vs continuous pulse oximetry monitoring on hospital length of stay among nonhypoxemic infants and young children hospitalized for bronchiolitis.

Key Study: Epinephrine Improves the Efficacy of Nebulized Hypertonic Saline in Moderate Bronchiolitis: A Randomised Clinical Trial

Visit

Flores-Gonzlez JC, Matamala-Morillo MA, Rodrguez-Campoy P, Prez-Guerrero JJ, ...

Objective: To evaluate the efficacy of nebulized epinephrine in 3% hypertonic saline.

Key Study: Bronchiolitis of Infancy Discharge Study (BIDS): a multicentre, parallel-group, double-blind, randomised controlled, equivalence trial with economic evaluation

Visit

Cunningham S, Rodriguez A, Boyd KA, McIntosh E, Lewis SC, BIDS Collaborators ...

Objective: To compare the American Academy of Pediatrics guideline target of SpO2 90% with the Scottish Intercollegiate Guidelines Network target of SpO2 94%.

Key Study: Nebulised hypertonic saline (3%) among children with mild to moderately severe bronchiolitis--a double blind randomized controlled trial

Visit

Khanal A, Sharma A, Basnet S, Sharma PR, Gami FC

Objective: To Assess the efficacy of nebulised hypertonic saline (HS) (3%) among children with mild to moderately severe bronchiolitis.

Key Study: Effect of oximetry on hospitalization in bronchiolitis: a randomized clinical trial

Visit

Schuh S, Freedman S, Coates A, Allen U, Parkin P, Stephens D, Ungar W, DaSilv...

Objective: To examine if infants with bronchiolitis whose displayed oximetry measurements have been artificially elevated 3 percentage points above true values experience hospitalization rates at least 15% lower compared with infants with true values displayed.

Key Study: Nasogastric hydration vs intravenous hydration for infants with bronchiolitis: a randomised trial

Visit

Oakley Ed, Borland M, () Babl F

Objective: to assess whether intravenous hydration or nasogastric hydration is better for treatment of infants.

Key Study: Epinephrine and dexamethasone in children with bronchiolitis

Visit

Plint AC, Johnson DW, Patel H, Wiebe N, Correll R, Brant R, Mitton C, Gouin S...

This randomized, double-blind, placebo-controlled, clinical trial with a factorial design at multiple sites was undertaken to determine whether treatment with nebulized epinephrine, a short course of oral dexamethasone, or both resulted in a clinically important decrease in hospital admissions among infants with bronchiolitis who were seen in the emergency department.

Key Study: A cost-effectiveness analysis of omitting radiography in diagnosis of acute bronchiolitis

Visit

Yong JHE, Schuh S, Rashidi R, Vanderby S, Lau R, Laporte A, Nauenberg E, Unga...

Objective:To carry out a cost-effectiveness analysis of omitting chest radiography in the diagnosis of infant bronchiolitis.

Key Study: A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis

Visit

Corneli HM, Zorc JJ, Mahajan P, Shaw KN, Holubkov R, Reeves SD, Ruddy RM, Mal...

The goal of this study was to determine the effectiveness of a single dose of oral dexamethasone in infants with moderate-to-severe bronchiolitis.

Key Study: Evaluation of the utility of radiography in acute bronchiolitis

Visit

Schuh S, Lalani A, Allen U, Manson D, Babyn P, Stephens D, MacPhee S, Mokansk...

Objectives: to determine the proportion of radiographs inconsistent with bronchiolitis in children with typical presentation of bronchiolitis and to compare rates of intended antibiotic therapy before radiography versus those given antibiotics after radiography.

Key Study: Risk of serious bacterial infection in young febrile infants with respiratory syncytial virus infections

Visit

Levine DA, Platt SL, Dayan PS, Macias CG, Zorc JJ, Krief W, Schor J, Bank D, ...

Objective: to determine the risk of SBI in young febrile infants who are infected with RSV compared with those without RSV infections.

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