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Resources in Evidence Repository and Individual Compendia

Key Resources

Bottom Line Recommendations: Bronchiolitis  (2020)

Bottom Line Recommendations: Bronchiolitis

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Plint, A & TREKK Network

Plint, A & TREKK Network

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. Posted online: January 14, 2021, Version 3.0.

Recommandations de Base: La Bronchiolite  (2020)

Recommandations de Base: La Bronchiolite

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Plint, A & TREKK Network

Plint, A & TREKK Network

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 - en francais.  Published online: January 14, 2021, Version 3.0.

Clinical guidelines

Clinical Guideline: Bronchiolitis: Recommendations for diagnosis, monitoring and management of children one to 24 months of age  (2014)

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

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Canadian Paediatric Society

Canadian Paediatric Society

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.

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.

Clinical Guideline: Bronchiolitis in children: diagnosis and management  (2015)

Clinical Guideline: Bronchiolitis in children: diagnosis and management

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NICE guideline (NG9)

NICE guideline (NG9)

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.

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.

Australasian bronchiolitis bedside clinical guideline  (2018)

Australasian bronchiolitis bedside clinical guideline

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Sharon O'Brien et al on behalf of PREDICT Network Australasia

Sharon O'Brien et al on behalf of PREDICT Network Australasia

This guideline has been developed to provide an evidence-based clinical framework for the management of infants (012 months) with bronchiolitis treated in Australasian emergency departments (EDs) or general paediatric wards. Application of these guidelines for children over 12 months may be relevant but there is less diagnostic certainty in the 1224 month age group. (All references to age within this guideline refer to chronological age unless stated otherwise).

This guideline has been developed to provide an evidence-based clinical framework for the management of infants (012 months) with bronchiolitis treated in Australasian emergency departments (EDs) or general paediatric wards. Application of these guidelines for children over 12 months may be relevant but there is less diagnostic certainty in the 1224 month age group. (All references to age within this guideline refer to chronological age unless stated otherwise).

Clinical Guideline: Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis  (2014)

Clinical Guideline: Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis

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Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, Johnson DW, Light MJ, Maraqa NF, Mendonca EA, Phelan KJ, Zorc JJ, Stanko-Lopp D, ...

Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, J...

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.

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.

Clinical Guideline: Australasian bronchiolitis guideline  (2019)

Clinical Guideline: Australasian bronchiolitis guideline

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PREDICT Network: OBrien S, Borland ML, Cotterell E, Armstrong D, Babl Franz, Bauert P, Brabyn C, Garside L, Haskell L, Levitt D, McKay N, Neutze J, Schiller ...

PREDICT Network: OBrien S, Borland ML, Cotterell E, Armstrong D, Babl Franz, ...

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

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

Overviews of systematic reviews

Cochrane Summary: Hypertonic saline solution administered via nebuliser for acute bronchiolitis in infants  (2013)

Cochrane Summary: Hypertonic saline solution administered via nebuliser for acute bronchiolitis in infants

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Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP

Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP

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

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

Cochrane Summary: Glucocorticoids for acute viral bronchiolitis in infants and young children under two years of age  (2013)

Cochrane Summary: Glucocorticoids for acute viral bronchiolitis in infants and young children under two years of age

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Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson DW, Klassen TP, Hartling L

Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson ...

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

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

Cochrane Summary: Epinephrine for acute viral bronchiolitis in children less than two years of age  (2011)

Cochrane Summary: Epinephrine for acute viral bronchiolitis in children less than two years of age

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Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, Klassen TP, Patel H, Fernandes RM

Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, Klassen...

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

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

Cochrane Summary: Antibiotics for bronchiolitis in children under two years of age  (2014)

Cochrane Summary: Antibiotics for bronchiolitis in children under two years of age

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Farley R, Spurling GK, Eriksson L, Del Mar CB

Farley R, Spurling GK, Eriksson L, Del Mar CB

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

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

Cochrane Summary: Bronchodilators for bronchiolitis for infants with first-time wheezing  (2014)

Cochrane Summary: Bronchodilators for bronchiolitis for infants with first-time wheezing

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Gadomski AM, Scribani MB

Gadomski AM, Scribani MB

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

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

Overview of Systematic Reviews: The Cochrane Library and the treatment of bronchiolitis in children: An overview of reviews  (2011)

Overview of Systematic Reviews: The Cochrane Library and the treatment of bronchiolitis in children: An overview of reviews

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Bialy L, Foisy M, Smith M, Fernandes RM

Bialy L, Foisy M, Smith M, Fernandes RM

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.

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.

Overview of Systematic Reviews: Evidence Summary: Bronchiolitis  (2014)

Overview of Systematic Reviews: Evidence Summary: Bronchiolitis

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Alberta Research Centre for Health Evidence (ARCHE)

Alberta Research Centre for Health Evidence (ARCHE)

Evidence summary for the treatment and management of bronchiolitis.

Evidence summary for the treatment and management of bronchiolitis.

Overview of Systematic Reviews: The Cochrane Library and safety of systemic corticosteroids for acute respiratory conditions in children: An overview of reviews  (2014)

Overview of Systematic Reviews: The Cochrane Library and safety of systemic corticosteroids for acute respiratory conditions in children: An overview of reviews

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Fernandes RM, Oleszczuk M, Woods CR, Rowe BH, Cates CJ, Hartling L.

Fernandes RM, Oleszczuk M, Woods CR, Rowe BH, Cates CJ, Hartling L.

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 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.

Systematic reviews

Meta-analysis: Association of diagnostic criteria with urinary tract infection prevalence in bronchiolitis: a systematic review and meta-analysis  (2019)

Meta-analysis: Association of diagnostic criteria with urinary tract infection prevalence in bronchiolitis: a systematic review and meta-analysis

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McDaniel C, Ralston S, Lucas B, Schroeder AR

McDaniel C, Ralston S, Lucas B, Schroeder AR

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 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.

Systematic Review: Glucocorticoids for acute viral bronchiolitis in infants and young children  (2013)

Systematic Review: Glucocorticoids for acute viral bronchiolitis in infants and young children

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Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson DW, Klassen TP, Hartling L

Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson ...

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

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

Systematic Review: Nebulised hypertonic saline solution for acute bronchiolitis in infants  (2013)

Systematic Review: Nebulised hypertonic saline solution for acute bronchiolitis in infants

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Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP

Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP

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

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

Systematic Review: Epinephrine for bronchiolitis  (2011)

Systematic Review: Epinephrine for bronchiolitis

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Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, Klassen TP, Patel H, Fernandes RM

Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, Klassen...

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

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

Systematic Review: Steroids and bronchodilators for acute bronchiolitis in the first two years of life: systematic review and meta-analysis  (2011)

Systematic Review: Steroids and bronchodilators for acute bronchiolitis in the first two years of life: systematic review and meta-analysis

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Hartling L, Fernandes RM, Bialy L, Milne A, Johnson D, Plint A, Klassen TP, Vandermeer B

Hartling L, Fernandes RM, Bialy L, Milne A, Johnson D, Plint A, Klassen TP, V...

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.

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.

Cochrane Systematic Review: Heliox inhalation therapy for bronchiolitis in infants

Cochrane Systematic Review: Heliox inhalation therapy for bronchiolitis in infants

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Liet JM, Ducruet T, Gupta V, Cambonie G.

Liet JM, Ducruet T, Gupta V, Cambonie G.

Objectives: To assess heliox in addition to standard medical care for acute bronchiolitis in infants.

Objectives: To assess heliox in addition to standard medical care for acute bronchiolitis in infants.

Cochrane Systematic Review: Inhaled corticosteroids during acute bronchiolitis in the prevention of post-bronchiolitic wheezing

Cochrane Systematic Review: Inhaled corticosteroids during acute bronchiolitis in the prevention of post-bronchiolitic wheezing

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Blom DJ, Ermers M, Bont L, van Woensel JB, Van Aalderen WM.

Blom DJ, Ermers M, Bont L, van Woensel JB, Van Aalderen WM.

Objectives: The objective of this review was to evaluate the effect of inhaled corticosteroids, started during the acute phase of bronchiolitis, on the prevention of post-bronchiolitic wheezing.

Objectives: The objective of this review was to evaluate the effect of inhaled corticosteroids, started during the acute phase of bronchiolitis, on the prevention of post-bronchiolitic wheezing.

Cochrane Systematic Review: Nebulised deoxyribonuclease for viral bronchiolitis in children younger than 24 months

Cochrane Systematic Review: Nebulised deoxyribonuclease for viral bronchiolitis in children younger than 24 months

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Enriquez A, Chu IW, Mellis C, Lin WY.

Enriquez A, Chu IW, Mellis C, Lin WY.

Objectives: To determine the effect of nebulised rhDNase on the severity and duration of viral bronchiolitis in children younger than 24 months of age in the hospital setting.

Objectives: To determine the effect of nebulised rhDNase on the severity and duration of viral bronchiolitis in children younger than 24 months of age in the hospital setting.

Cochrane Systematic Review: Steam inhalation or humidified oxygen for acute bronchiolitis in children up to three years of age

Cochrane Systematic Review: Steam inhalation or humidified oxygen for acute bronchiolitis in children up to three years of age

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Umoren R, Odey F, Meremikwu MM.

Umoren R, Odey F, Meremikwu MM.

Objectives: To evaluate the effect of steam inhalation or humidified oxygen to relieve respiratory distress and to evaluate adverse events in children up to three years old with acute bronchiolitis.

Objectives: To evaluate the effect of steam inhalation or humidified oxygen to relieve respiratory distress and to evaluate adverse events in children up to three years old with acute bronchiolitis.

Cochrane Systematic Review: Surfactant therapy for bronchiolitis in critically ill infants

Cochrane Systematic Review: Surfactant therapy for bronchiolitis in critically ill infants

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Ventre K, Haroon M, Davison C.

Ventre K, Haroon M, Davison C.

Objectives: To assess the efficacy of exogenous surfactant for the treatment of bronchiolitis in mechanically ventilated infants and children.

Objectives: To assess the efficacy of exogenous surfactant for the treatment of bronchiolitis in mechanically ventilated infants and children.

Cochrane Systematic Review: Antibiotics for persistent cough or wheeze following acute bronchiolitis in children

Cochrane Systematic Review: Antibiotics for persistent cough or wheeze following acute bronchiolitis in children

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McCallum GB, Morris PS, Chang AB.

McCallum GB, Morris PS, Chang AB.

Objectives: To determine the effectiveness of antibiotics compared to a control (no treatment or placebo) for persistent respiratory symptoms (within six months), following acute bronchiolitis.

Objectives: To determine the effectiveness of antibiotics compared to a control (no treatment or placebo) for persistent respiratory symptoms (within six months), following acute bronchiolitis.

Systematic Review: Antibiotics for bronchiolitis in children under two years of age  (2014)

Systematic Review: Antibiotics for bronchiolitis in children under two years of age

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Farley R, Spurling GK, Eriksson L, Del Mar CB

Farley R, Spurling GK, Eriksson L, Del Mar CB

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

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

Systematic Review: Bronchodilators for bronchiolitis  (2014)

Systematic Review: Bronchodilators for bronchiolitis

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Gadomski AM, Scribani MB

Gadomski AM, Scribani MB

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.

Cochrane Systematic Review: Antibiotics for bronchiolitis in children

Cochrane Systematic Review: Antibiotics for bronchiolitis in children

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Spurling GK, Doust J, Del Mar CB, Eriksson L

Spurling GK, Doust J, Del Mar CB, Eriksson L

OBJECTIVES: To evaluate the effectiveness of antibiotics for bronchiolitis.

OBJECTIVES: To evaluate the effectiveness of antibiotics for bronchiolitis.

Cochrane Systematic Review: Bronchodilators for bronchiolitis

Cochrane Systematic Review: Bronchodilators for bronchiolitis

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Gadomski AM, Scribani MB

Gadomski AM, Scribani MB

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

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

Cochrane Systematic Review: Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old

Cochrane Systematic Review: Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old

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Roqu i Figuls M, Gin-Garriga M, Granados Rugeles C, Perrotta C

Roqu i Figuls M, Gin-Garriga M, Granados Rugeles C, Perrotta C

OBJECTIVES: The main objective was to determine the efficacy of chest physiotherapy in infants aged less than 24 months old with acute bronchiolitis. A condary objective was to determine the efficacy of different techniques of chest physiotherapy (for ample, vibration and percussion and passive forced exhalation).

OBJECTIVES: The main objective was to determine the efficacy of chest physiotherapy in infants aged less than 24 months old with acute bronchiolitis. A condary objective was to determine the efficacy of different techniques of chest physiotherapy (for ample, vibration and percussion and passive forced exhalation).

Cochrane Systematic Review: Epinephrine for bronchiolitis

Cochrane Systematic Review: Epinephrine for bronchiolitis

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Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, Klassen TP, Patel H, Fernandes RM.

Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, Klassen...

Objectives: To examine the efficacy and safety of epinephrine in children less than two with viral bronchiolitis.

Objectives: To examine the efficacy and safety of epinephrine in children less than two with viral bronchiolitis.

Cochrane Systematic Review: Glucocorticoids for viral bronchiolitis in infants and young children

Cochrane Systematic Review: Glucocorticoids for viral bronchiolitis in infants and young children

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Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson DW, Klassen TP, Hartling L.

Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson ...

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

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

Cochrane Systematic Review: Nebulised hypertonic saline solution for acute bronchiolitis in infants

Cochrane Systematic Review: Nebulised hypertonic saline solution for acute bronchiolitis in infants

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Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP.

Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP.

Objectives: To assess the effects of nebulised hypertonic ( 3%) saline solution in infants with viral bronchiolitis.

Objectives: To assess the effects of nebulised hypertonic ( 3%) saline solution in infants with viral bronchiolitis.

Systematic Review: Nebulized hypertonic saline for acute bronchiolitis: A systematic review  (2015)

Systematic Review: Nebulized hypertonic saline for acute bronchiolitis: A systematic review

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Zhang L, Mendoza-Sassi RA, Klassen TP, Wainwright C.

Zhang L, Mendoza-Sassi RA, Klassen TP, Wainwright C.

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

Meta-analysis: Efficacy of salbutamol in the treatment of infants with bronchiolitis: a meta-analysis of 13 studies  (2020)

Meta-analysis: Efficacy of salbutamol in the treatment of infants with bronchiolitis: a meta-analysis of 13 studies

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Cai Z, Lin Y, Liang J

Cai Z, Lin Y, Liang J

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

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

Systematic review: High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis  (2019)

Systematic review: High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis

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Lin, J. Z., Y.; Xiong, L.; Liu, S.; Gong, C.; Dai, J.

Lin, J. Z., Y.; Xiong, L.; Liu, S.; Gong, C.; Dai, J.

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

Cochrane Systematic Review: Continuous positive airway pressure (CPAP) for acute bronchiolitis in children  (2019)

Cochrane Systematic Review: Continuous positive airway pressure (CPAP) for acute bronchiolitis in children

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KR Jat, JL Mathew

KR Jat, JL Mathew

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 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.

Meta-analysis: Hypertonic saline in bronchiolitis and type 1 error: a trial sequential analysis  (2018)

Meta-analysis: Hypertonic saline in bronchiolitis and type 1 error: a trial sequential analysis

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Harrison W, Angoulvant F, House S, Gajdos V, Ralston SL

Harrison W, Angoulvant F, House S, Gajdos V, Ralston SL

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

Cochrane Systematic Review: Nebulised hypertonic saline solution for acute bronchiolitis in infants  (2017)

Cochrane Systematic Review: Nebulised hypertonic saline solution for acute bronchiolitis in infants

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Zhang L, Mendoza-Sassi RA, Wainwright C,Klassen TP

Zhang L, Mendoza-Sassi RA, Wainwright C,Klassen TP

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

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

Cochrane Systematic Review: Heliox inhalation therapy for bronchiolitis in infants  (2015)

Cochrane Systematic Review: Heliox inhalation therapy for bronchiolitis in infants

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Liet JM, Ducruet T, Gupta V, Cambonie G

Liet JM, Ducruet T, Gupta V, Cambonie G

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 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).

Cochrane Systematic Review: Bronchodilators for bronchiolitis  (2014)

Cochrane Systematic Review: Bronchodilators for bronchiolitis

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Gadomski AM, Scribani MB

Gadomski AM, Scribani MB

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.

Cochrane Systematic Review: Glucocorticoids for acute viral bronchiolitis in infants and young children under two years of age  (2013)

Cochrane Systematic Review: Glucocorticoids for acute viral bronchiolitis in infants and young children under two years of age

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Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson DW, Klassen TP, Hartling L

Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson ...

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

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

High flow nasal cannula as respiratory support in treating infant bronchiolitis: a systematic review.  (2020)

High flow nasal cannula as respiratory support in treating infant bronchiolitis: a systematic review.

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Moreel L, Proesmans M

Moreel L, Proesmans M

In this review, we critically summarize the data from these RCTs with the aim to provide advice on how to position HFNC in clinical practice.Conclusion: HFNC is a safe mode of respiratory support that can be positioned between SOT and nCPAP as rescue therapy for children not adequately supported by SOT. It does not seem to shorten the duration of oxygen need nor the duration of hospital admission

In this review, we critically summarize the data from these RCTs with the aim to provide advice on how to position HFNC in clinical practice.Conclusion: HFNC is a safe mode of respiratory support that can be positioned between SOT and nCPAP as rescue therapy for children not adequately supported by SOT. It does not seem to shorten the duration of oxygen need nor the duration of hospital admission

High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis.  (2019)

High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis.

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Lin J, Zhang Y, Xiong L, Liu S, Gong C, Dai J.

Lin J, Zhang Y, Xiong L, Liu S, Gong C, Dai J.

To review the effects and safety of high-flow nasal cannula (HFNC) for bronchiolitis.

To review the effects and safety of high-flow nasal cannula (HFNC) for bronchiolitis.

Rational use of high-flow therapy in infants with bronchiolitis. What do the latest trials tell us?' A Paediatric Research in Emergency Departments International Collaborative perspective.  (2019)

Rational use of high-flow therapy in infants with bronchiolitis. What do the latest trials tell us?' A Paediatric Research in Emergency Departments International Collaborative perspective.

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O'Brien S, Craig S, Babl FE, Borland ML, Oakley E, Dalziel SR; Paediatric Research in Emergency Departments International Collaborative (PREDICT)

O'Brien S, Craig S, Babl FE, Borland ML, Oakley E, Dalziel SR; Paediatric Res...

Over the past decade, the use of high-flow nasal cannulae (HFNC) therapy has increased markedly and it is now utilised not only in the intensive care unit setting but in general paediatric wards and emergency departments. The aim of this systematic review was to summarise and critique the current evidence-base for the use of HFNC in infants with bronchiolitis.

Over the past decade, the use of high-flow nasal cannulae (HFNC) therapy has increased markedly and it is now utilised not only in the intensive care unit setting but in general paediatric wards and emergency departments. The aim of this systematic review was to summarise and critique the current evidence-base for the use of HFNC in infants with bronchiolitis.

Cochrane Systematic Review: Oxygen therapy for lower respiratory tract infections in children between 3 months and 15 years of age

Cochrane Systematic Review: Oxygen therapy for lower respiratory tract infections in children between 3 months and 15 years of age

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Rojas MX, Granados Rugeles C, Charry-Anzola LP.

Rojas MX, Granados Rugeles C, Charry-Anzola LP.

Objectives: To determine in the treatment of LRTIs: the effectiveness of oxygen therapy and oxygen delivery methods; the safety of these methods; and indications for oxygen therapy.

Objectives: To determine in the treatment of LRTIs: the effectiveness of oxygen therapy and oxygen delivery methods; the safety of these methods; and indications for oxygen therapy.

Key studies

Key Study: A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis  (2007)

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

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Corneli HM, Zorc JJ, Mahajan P, Shaw KN, Holubkov R, Reeves SD, Ruddy RM, Malik B, Nelson KA, Bregstein JS, Brown KM, Denenberg MN, Lillis KA, Cimpello LB, T...

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.

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: Epinephrine and dexamethasone in children with bronchiolitis  (2009)

Key Study: Epinephrine and dexamethasone in children with bronchiolitis

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Plint AC, Johnson DW, Patel H, Wiebe N, Correll R, Brant R, Mitton C, Gouin S, Bhatt M, Joubert G, Black KJ, Turner T, Whitehouse S, Klassen TP; Pediatric Em...

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.

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: Evaluation of the utility of radiography in acute bronchiolitis  (2007)

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

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Schuh S, Lalani A, Allen U, Manson D, Babyn P, Stephens D, MacPhee S, Mokanski M, Khaikin S, Dick P

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.

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: High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): An open, phase 4, randomised controlled trial  (2017)

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

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Kepreotes E, Whitehead B, Attia J, Oldmeadow C, Collison A, Searles A, Goddard B, Hilton J, Lee M, Mattes J

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

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: Association of Fluid Overload with Clinical Outcomes in Critically Ill Children with Bronchiolitis: Bronquiolitis en la Unidad de Cuidados Intensivos Pediatricos (BRUCIP) Study*  (2019)

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*

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Flores-Gonzalez, J. C. V., C. M.; Yun Castilla, C.; Mayordomo-Colunga, J.; Quesada, S. P.; Martin Delgado, C. M.; Goni-Orayen, C.; Fernandez Carrion, F.; Vei...

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.

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]  (2019)

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]

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Seliem, W and Sultan, AM

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.

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  (2019)

Key Study: Chest radiography in children hospitalized with bronchiolitis

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Wrotek A, Czajkowska M, Jackowska T

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.

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  (2018)

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

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Franklin, D. B., F. E.; Schlapbach, L. J.; Oakley, E.; Craig, S.; Neutze, J.; Furyk, J.; Fraser, J. F.; Jones, M.; Whitty, J. A.; Dalziel, S. R.; Schibler, A.

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).

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  (2018)

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

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Seliem, W. S., A. M.

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.

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  (2018)

Key Study: Predicting escalated care in infants with bronchiolitis

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Freire

Freire

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

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

Key Study: Predictors of critical care and mortality in bronchiolitis after emergency department discharge  (2018)

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

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

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.

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  (2018)

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

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

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.

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: Effect of nebulized hypertonic saline treatment in emergenc departments on hospitalization rate for acute bronchiolitis: a randomized clinical trial  (2017)

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

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Angoulvant F, Belletre X, Milcent K, et al

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.

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)  (2017)

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)

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Milsi C, Essouri S, Pouyau R, Liet JM, Afanetti M, Portefaix A, Baleine J,Durand S, Combes C, Douillard A, Cambonie G, Groupe Francophone de Ranimation et dU...

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).

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  (2016)

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

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

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.

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  (2016)

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

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

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.

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  (2015)

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

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McCulloh R, Koster M, Ralston S, Johnson M, Hill V, Koehn K, Weddle G, Alverson B

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.

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  (2015)

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

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Flores-Gonzlez JC, Matamala-Morillo MA, Rodrguez-Campoy P, Prez-Guerrero JJ, Serrano-Moyano B, Comino-Vazquez P, Palma-Zambrano E, Bulo-Concelln R, Santos-Sn...

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

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

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  (2015)

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

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

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%.

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  (2015)

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

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

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.

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  (2014)

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

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Schuh S, Freedman S, Coates A, Allen U, Parkin P, Stephens D, Ungar W, DaSilva Z, Willan A

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.

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  (2013)

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

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Oakley Ed, Borland M, () Babl F

Oakley Ed, Borland M, () Babl F

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

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

Key Study: A cost-effectiveness analysis of omitting radiography in diagnosis of acute bronchiolitis  (2009)

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

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Yong JHE, Schuh S, Rashidi R, Vanderby S, Lau R, Laporte A, Nauenberg E, Ungar WJ

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.

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

High flow nasal cannula and continuous positive airway pressure therapy in treatment of viral bronchiolitis: a randomized clinical trial.  (2020)

High flow nasal cannula and continuous positive airway pressure therapy in treatment of viral bronchiolitis: a randomized clinical trial.

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Vahlkvist S, Jrgensen L, la Cour A, Markoew S, Petersen TH, Kofoed PE.

Vahlkvist S, Jrgensen L, la Cour A, Markoew S, Petersen TH, Kofoed PE.

Continuous positive airway pressure (CPAP) has been used in infants with bronchiolitis for decades. Recently, high flow nasal cannula (HFNC) therapy was introduced. We conducted a trial of 50 children with bronchiolitis who were randomized to treatment with CPAP or HFNC. Objectives were to compare the development in respiratory rate, pCO2, and Modified Woods Clinical Asthma Score (M-WCAS) in young children with bronchiolitis, treated with CPAP or HFNC. Secondarily, to compare Neonatal Infant Pain Score (NIPS), treatment duration, treatment failure, and hospitalization length.

Continuous positive airway pressure (CPAP) has been used in infants with bronchiolitis for decades. Recently, high flow nasal cannula (HFNC) therapy was introduced. We conducted a trial of 50 children with bronchiolitis who were randomized to treatment with CPAP or HFNC. Objectives were to compare the development in respiratory rate, pCO2, and Modified Woods Clinical Asthma Score (M-WCAS) in young children with bronchiolitis, treated with CPAP or HFNC. Secondarily, to compare Neonatal Infant Pain Score (NIPS), treatment duration, treatment failure, and hospitalization length.

A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis.  (2018)

A Randomized Trial of High-Flow Oxygen Therapy in Infants with Bronchiolitis.

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Franklin D, Babl FE, Schlapbach LJ, Oakley E, Craig S, Neutze J, et al.

Franklin D, Babl FE, Schlapbach LJ, Oakley E, Craig S, Neutze J, et al.

High-flow oxygen therapy through a nasal cannula has been increasingly used in infants with bronchiolitis, despite limited high-quality evidence of its efficacy. The efficacy of high-flow oxygen therapy through a nasal cannula in settings other than intensive care units (ICUs) is unclear. Among infants with bronchiolitis who were treated outside an ICU, those who received high-flow oxygen therapy had significantly lower rates of escalation of care due to treatment failure than those in the group that received standard oxygen therapy.

High-flow oxygen therapy through a nasal cannula has been increasingly used in infants with bronchiolitis, despite limited high-quality evidence of its efficacy. The efficacy of high-flow oxygen therapy through a nasal cannula in settings other than intensive care units (ICUs) is unclear. Among infants with bronchiolitis who were treated outside an ICU, those who received high-flow oxygen therapy had significantly lower rates of escalation of care due to treatment failure than those in the group that received standard oxygen therapy.

High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): an open, phase 4, randomised controlled trial.  (2017)

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

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

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

We aimed to examine whether HFWHO provided enhanced respiratory support, thereby shortening time to weaning off oxygen. HFWHO did not significantly reduce time on oxygen compared with standard therapy, suggesting that early use of HFWHO does not modify the underlying disease process in moderately severe bronchiolitis. HFWHO might have a role as a rescue therapy to reduce the proportion of children requiring high-cost intensive care.

We aimed to examine whether HFWHO provided enhanced respiratory support, thereby shortening time to weaning off oxygen. HFWHO did not significantly reduce time on oxygen compared with standard therapy, suggesting that early use of HFWHO does not modify the underlying disease process in moderately severe bronchiolitis. HFWHO might have a role as a rescue therapy to reduce the proportion of children requiring high-cost intensive care.

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).  (2017)

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).

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Milsi C, Essouri S, Pouyau R, Liet JM, Afanetti M, Portefaix A, et al.

Milsi C, Essouri S, Pouyau R, Liet JM, Afanetti M, Portefaix A, et al.

Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute viral bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants. In young infants with moderate to severe AVB, initial management with HFNC did not have a failure rate similar to that of nCPAP.

Nasal continuous positive airway pressure (nCPAP) is currently the gold standard for respiratory support for moderate to severe acute viral bronchiolitis (AVB). Although oxygen delivery via high flow nasal cannula (HFNC) is increasingly used, evidence of its efficacy and safety is lacking in infants. In young infants with moderate to severe AVB, initial management with HFNC did not have a failure rate similar to that of nCPAP.

Safety of High-Flow Nasal Cannula Outside the ICU for Previously Healthy Children With Bronchiolitis.  (2019)

Safety of High-Flow Nasal Cannula Outside the ICU for Previously Healthy Children With Bronchiolitis.

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Dadlez NM, Esteban-Cruciani N, Khan A, Shi Y, McKenna KJ, Azzarone G, et al.

Dadlez NM, Esteban-Cruciani N, Khan A, Shi Y, McKenna KJ, Azzarone G, et al.

High-flow nasal cannula (HFNC), a form of noninvasive respiratory support, is effective for the treatment of respiratory distress in ICUs. Although HFNC has been used outside of the ICU, there is little research that examines its safety in this less-monitored setting. HFNC may be a safe modality of respiratory support outside of the ICU for children ages 24 months with bronchiolitis and without comorbidities up to a maximum flow of 10 L/min. There were no adverse events among the subjects who were fed while on HFNC.

High-flow nasal cannula (HFNC), a form of noninvasive respiratory support, is effective for the treatment of respiratory distress in ICUs. Although HFNC has been used outside of the ICU, there is little research that examines its safety in this less-monitored setting. HFNC may be a safe modality of respiratory support outside of the ICU for children ages 24 months with bronchiolitis and without comorbidities up to a maximum flow of 10 L/min. There were no adverse events among the subjects who were fed while on HFNC.

A two-tiered high-flow nasal cannula approach to bronchiolitis was associated with low admission rate to intensive care and no adverse outcomes.  (2019)

A two-tiered high-flow nasal cannula approach to bronchiolitis was associated with low admission rate to intensive care and no adverse outcomes.

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Daverio M, Da Dalt L, Panozzo M, Frigo AC, Bressan S

Daverio M, Da Dalt L, Panozzo M, Frigo AC, Bressan S

We aimed to describe the characteristics and outcomes of infants with bronchiolitis who received high-flow nasal cannula oxygen (HFNC) following a two-tiered approach. A two-tiered approach to HFNC use in bronchiolitis was associated with low intensive care admissions and no adverse outcomes.

We aimed to describe the characteristics and outcomes of infants with bronchiolitis who received high-flow nasal cannula oxygen (HFNC) following a two-tiered approach. A two-tiered approach to HFNC use in bronchiolitis was associated with low intensive care admissions and no adverse outcomes.

Key Study: Risk of serious bacterial infection in young febrile infants with respiratory syncytial virus infections  (2004)

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

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Levine DA, Platt SL, Dayan PS, Macias CG, Zorc JJ, Krief W, Schor J, Bank D, Fefferman N, Shaw KN, Kuppermann N

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.

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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Emergency Medicine Cases Podcast: Bronchiolitis  (2015)

Emergency Medicine Cases Podcast: Bronchiolitis

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Dr. Dennis Scolnik & Dr. Sanjay Mehta

Dr. Dennis Scolnik & Dr. Sanjay Mehta

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 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. 

Emergency Medicine Cases Podcast: Bronchiolitis Part 2  (2015)

Emergency Medicine Cases Podcast: Bronchiolitis Part 2

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Dr. Amy Plint

Dr. Amy Plint

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 

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 

TREKK.ca Info Pages

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