Bronchiolitis

Bottom line recommendations for the treatment and management of bronchiolitis - en francais.  Published online: January 14, 2021, Version 3.0.

Bottom line recommendations for the treatment and management of bronchiolitis. Posted online: January 14, 2021, Version 3.0.

Bottom line recommendations for the treatment and management of bronchiolitis - en francais.  Published online: January 14, 2021, Version 3.0.

Objective: to align and improve the consistency of the management of bronchiolitis, an evidence-based guideline was developed for the Australasian population.

Objective: to help healthcare professionals diagnose bronchiolitis and identify if children should be cared for at home or in hospital. It describes treatments and interventions that can be used to help with the symptoms of bronchiolitis.

This guideline is a revision of the clinical practice guideline, Diagnosis and Management of Bronchiolitis, published by the American Academy of Pediatrics in 2006. The guideline applies to children from 1 through 23 months of age. Other exclusions are noted. Each key action statement indicates level of evidence, benefit-harm relationship, and level of recommendation.

The goals of this statement are to build on the comprehensive peer-reviewed AAP statement by incorporating new evidence published over the past eight years, while providing the clinician with recommendations to help guide diagnosis, monitoring and management of previously healthy children one to 24 months of age who present with signs of bronchiolitis.

Evidence summary for the treatment and management of bronchiolitis.

This review summarizes evidence on the effect of antibiotics on clinical outcomes in children with bronchiolitis.

This review summarizes the evidence about the effect of bronchodilators in infants with bronchiolitis.

Objective: To examine clinically relevant short-term safety outcomes related to acute single or recurrent systemic short-term (<2 weeks) corticosteroid use based on systematic reviews of acute respiratory conditions.

Objective: to assess the effects of nebulised hypertonic ( 3%) saline solution in infants with acute viral bronchiolitis.

Objective: to review the efficacy and safety of systemic and inhaled glucocorticoids in children with acute viral bronchiolitis.

This updated overview of reviews aims to synthesize evidence from the Cochrane Database of Systematic Reviews (CDSR) on the effectiveness and safety of 11 pharmacologic and non-pharmacologic treatments to improve bronchiolitis symptoms in outpatient, inpatient and intensive care populations.

Objective: to examine the efficacy and safety of epinephrine in children less than two with acute viral bronchiolitis.

Objective: To systematically evaluate the clinical efficacy of salbutamol treatment in infants with bronchiolitis.

Objective: To determine whether treatment with CNHD is more effective than other non-invasive forms of treatment in pediatric patients who require respiratory support.

Objective: To assess the efficacy and safety of CPAP compared to no or sham CPAP in infants and children under three years of age with acute bronchiolitis.

Objective: To conduct a systematic review and meta-analysis examining the prevalence of UTI in infants with bronchiolitis when positive UA results are incorporated into the UTI definition.

Objective: to use TSA to determine if the existing literature base is sufficient to draw firm conclusions about the effectiveness of HS in bronchiolitis.

Objective: to assess the effects of nebulizing hypertonic saline ( 3%) in infants with acute bronchiolitis.

Objective: The objective of this study was to assess the efficacy and safety of nebulized hypertonic saline (HS) in infants with acute bronchiolitis.

Objective: To assess heliox inhalation therapy in addition to standard medical care for acute bronchiolitis in infants with respiratory distress, as measured by clinical endpoints (in particular the rate of endotracheal intubation, the rate of emergency department discharge, the length of treatment for respiratory distress) and pulmonary function testing (mainly clinical respiratory scores).

Objective: to evaluate the effectiveness of antibiotics for bronchiolitis in children under two years of age compared to placebo or other interventions.

Objective: to assess the effects of bronchodilators on clinical outcomes in infants (0 to 12 months) with acute bronchiolitis.

Objective: To assess the effects of bronchodilators on clinical outcomes in infants (0 to 12 months) with acute bronchiolitis.

Objective: to review the efficacy and safety of systemic and inhaled glucocorticoids in children with acute viral bronchiolitis.

Objective: to assess the effects of nebulised hypertonic ( 3%) saline solution in infants with acute viral bronchiolitis.

Objective: To review the efficacy and safety of systemic and inhaled glucocorticoids in children with acute viral bronchiolitis.

Objective: to examine the efficacy and safety of epinephrine in children less than two with acute viral bronchiolitis.

Objectives: to evaluate and compare the efficacy and safety of bronchodilators and steroids, alone or combined, for the acute management of bronchiolitis in children aged less than 2 years.

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.

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.

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.

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

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.

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

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.

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.

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

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

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

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.

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.

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.

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

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

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

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.

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

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.

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

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

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.

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

Bronchiolitis is a viral infection, commonly caused by respiratory syncytial virus (RSV), that affects the lower part of the lungs. It mainly affects babies and young children under 2 and is very contagious. This infographic provides information on the symptoms of bronchiolitis, how to manage it at home, and when to seek emergency care.

This infographic was created through a collaboration between ECHO Research (University of Alberta), TREKK, and ARCHE (University of Alberta). Funding was provided by the Networks of Centres of Excellence and the Stollery Children’s Hospital Foundation through the Women and Children’s Health Research Institute.

Bronchiolitis is a viral infection, commonly caused by respiratory syncytial virus (RSV), that affects the lower part of the lungs. It mainly affects babies and young children under 2 and is very contagious. This video provides information on the symptoms of bronchiolitis, how to manage it at home, and when to seek emergency care.

This video was created through a collaboration between ECHO Research (University of Alberta), TREKK, and ARCHE (University of Alberta). Funding was provided by the Networks of Centres of Excellence and the Stollery Children’s Hospital Foundation through the Women and Children’s Health Research Institute.

Bronchiolitis is a viral infection, commonly caused by respiratory syncytial virus (RSV), that affects the lower part of the lungs. It mainly affects babies and young children under 2 and is very contagious. This eBook provides information on the symptoms of bronchiolitis, how to manage it at home, and when to seek emergency care.

This eBook was created through a collaboration between ECHO Research (University of Alberta), TREKK, and ARCHE (University of Alberta). Funding was provided by the Networks of Centres of Excellence and the Stollery Children’s Hospital Foundation through the Women and Children’s Health Research Institute.

Episode 59:This EM Cases episode is on the diagnosis and management of Bronchiolitis. Bronchiolitis is one of the most common diagnoses made in both general and pediatric EDs, and like many pediatric illnesses, theres a wide spectrum of severity of illness as well as a huge variation in practice in treating these children. Bronchiolitis rarely requires any work up yet a lot of resources are used unnecessarily. We need to know when to worry about these kids, as most of them will improve with simple interventions and can be discharged home, while a few will require complex care. Sometimes its difficult to predict which kids will do well and which kids wont.With the help of Dr. Dennis Scolnik, the clinical fellowship program director at Torontos only pediatric emergency department and Dr. Sanjay Mehta, an amazing educator who you might remember from his fantastic work on our Pediatric Ortho episode, well sort through how to assess the child with respiratory illness, how to predict which kids might run into trouble, and what the best evidence-based management of these kids is. 

Episode 59B: In response to Episode 59 with Dr. Sanjay Mehta and Dr. Dennis Scolnik on the emergency department diagnosis and management of Bronchiolitis, Dr. Amy Plint, one of Canadas most prominent researchers in Bronchiolitis and the Chair of Pediatric Emergency Research Canada, tells her practical approach to choosing medications in the emergency department, the take home message from her landmark 2009 NEJM study on the use of nebulized epinephrine and dexamethasone for treating Bronchiolitis, and the future of Bronchiolitis research. Published online: February 2015