Abstract

Review Article

An Update of Bronchiolitis - A Review

Md Atiar Rahman*

Published: 22 December, 2023 | Volume 7 - Issue 3 | Pages: 077-079

Bronchiolitis is one of the most common respiratory infections in children under 2 years of age predominantly caused by Respiratory syncytial virus and other viruses like influenza, Para influenza, and Adenovirus. Rhinovirus, etc. Most children have mild symptoms however bronchiolitis has also been well linked to severe morbidities and mortalities. Even though bronchiolitis has been well recognized for many years, there are still very few therapeutic strategies available beyond supportive management. There are many controversies about therapeutic management in bronchiolitis published in standard guidelines and research in this area. Management can be divided into pharmacological and supportive therapy. Evidence suggests that the current management of bronchiolitis is purely supportive consisting of oxygen supplementation, frequent suctioning, and maintaining good hydration and nutrition. Regarding pharmacological therapy, neither bronchodilators nor corticosteroids have significant efficacy in the treatment of bronchiolitis. However, some studies suggest that adrenaline and nebulizer 3% saline showed some benefit only in terms of outcome. The current recommendation also supports the use of Palivizumab as prophylaxis in certain groups of infants and young children.

Read Full Article HTML DOI: 10.29328/journal.acr.1001083 Cite this Article Read Full Article PDF

Keywords:

Bronchiolitis; Respiratory syncytial virus; Nebulized adrenaline; Nebulized 3% saline

References

  1. Centers for Disease Control and Prevention. RSV in infants and young children. 2020. https://www.cdc.gov/rsv/high-risk/infants-young-child ren.html.
  2. Public Health England. Respiratory syncytial virus (RSV): symptoms, transmission, prevention, treatment. 2008. https://www.gov.uk/government/publications/respiratory-syncytial-virus-rsv-symptoms-transmission-prevention-treatment/respiratory-syncytial-virus-rsv-sympt oms-transmission-prevention-treatment.
  3. Linssen RS, Teirlinck AC, van Boven M, Biarent D, Stona L, Amigoni A, Comoretto RI, Leteurtre S, Bruandet A, Bentsen GK, Drage IM, Wang X, Campbell H, van Woensel JBM, Bont L, Bem RA. Increasing burden of viral bronchiolitis in the pediatric intensive care unit; an observational study. J Crit Care. 2022 Apr;68:165-168. doi: 10.1016/j.jcrc.2021.07.009. Epub 2021 Jul 23. PMID: 34304966.
  4. Azzari C, Baraldi E, Bonanni P, Bozzola E, Coscia A, Lanari M, Manzoni P, Mazzone T, Sandri F, Checcucci Lisi G, Parisi S, Piacentini G, Mosca F. Epidemiology and prevention of respiratory syncytial virus infections in children in Italy. Ital J Pediatr. 2021 Oct 2;47(1):198. doi: 10.1186/s13052-021-01148-8. PMID: 34600591; PMCID: PMC8487331.
  5. Bakel LA, Hamid J, Ewusie J, Liu K, Mussa J, Straus S, Parkin P, Cohen E. International Variation in Asthma and Bronchiolitis Guidelines. Pediatrics. 2017 Nov;140(5):e20170092. doi: 10.1542/peds.2017-0092. PMID: 29070533.
  6. Japanese Society for Pediatric Infectious Diseases Pediatric respiratory infection clinical practice guidelines. 201. http://www.jspid.jp/pub/ sguideline.html.
  7. Verstraete M, Cros P, Gouin M, Oillic H, Bihouée T, Denoual H, Barzic A, Duigou AL, Vrignaud B, Levieux K, Vabres N, Fleurence E, Darviot E, Cardona J, Guitteny MA, Marot Y, Picherot G, Gras-Le Guen C. Prise en charge de la bronchiolite aiguë du nourrisson de moins de 1 an : actualisation et consensus médical au sein des hôpitaux universitaires du Grand Ouest (HUGO) [Update on the management of acute viral bronchiolitis: proposed guidelines of Grand Ouest University Hospitals]. Arch Pediatr. 2014 Jan;21(1):53-62. French. doi: 10.1016/j.arcped.2013.10.020. Epub 2013 Dec 8. PMID: 24321867.
  8. Nagakumar P, Doull I. Current therapy for bronchiolitis. Arch Dis Child. 2012 Sep;97(9):827-30. doi: 10.1136/archdischild-2011-301579. Epub 2012 Jun 25. PMID: 22734014.
  9. Zamora-Flores D, Busen NH, Smout R, Velasquez O. Implementing a clinical practice guideline for the treatment of bronchiolitis in a high-risk Hispanic pediatric population. J Pediatr Health Care. 2015 Mar-Apr;29(2):169-80. doi: 10.1016/j.pedhc.2014.10.002. Epub 2014 Nov 22. PMID: 25454385.
  10. Haas LE, Thijsen SF, van Elden L, Heemstra KA. Human metapneumovirus in adults. Viruses. 2013 Jan 8;5(1):87-110. doi: 10.3390/v5010087. PMID: 23299785; PMCID: PMC3564111.
  11. Da Dalt L, Bressan S, Martinolli F, Perilongo G, Baraldi E. Treatment of bronchiolitis: state of the art. Early Hum Dev. 2013 Jun;89 Suppl 1:S31-6. doi: 10.1016/S0378-3782(13)70011-2. PMID: 23809346.
  12. American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics. 2006 Oct;118(4):1774-93. doi: 10.1542/peds.2006-2223. PMID: 17015575.
  13. Hsieh CW, Chen C, Su HC, Chen KH. Exploring the efficacy of using hypertonic saline for nebulizing treatment in children with bronchiolitis: a meta-analysis of randomized controlled trials. BMC Pediatr. 2020 Sep 14;20(1):434. doi: 10.1186/s12887-020-02314-3. PMID: 32928154; PMCID: PMC7489028.
  14. Bronchiolitis in children. Scottish Intercollegiate Guidelines Network-SING. 2006.
  15. Bronchiolitis in children : diagnosis and management [Internet]. National Institute for Health and Care Excellence. 2023; 1–27. www.nice.org.uk/guidance/ng9
  16. Pereira RA, Oliveira de Almeida V, Zambrano M, Zhang L, Amantéa SL. Effects of nebulized epinephrine in association with hypertonic saline for infants with acute bronchiolitis: A systematic review and meta-analysis. Health Sci Rep. 2022 Apr 18;5(3):e598. doi: 10.1002/hsr2.598. PMID: 35509393; PMCID: PMC9059211.
  17. Nagakumar P, Doull I. Current therapy for bronchiolitis. Arch Dis Child. 2012 Sep;97(9):827-30. doi: 10.1136/archdischild-2011-301579. Epub 2012 Jun 25. PMID: 22734014.
  18. Blom DJ, Ermers M, Bont L, van Woensel JB, Van Aalderen WM. WITHDRAWN: Inhaled corticosteroids during acute bronchiolitis in the prevention of post-bronchiolitic wheezing. Cochrane Database Syst Rev. 2011 Jan 19;2011(1):CD004881. doi: 10.1002/14651858.CD004881.pub3. PMID: 21249665; PMCID: PMC10658823.
  19. Fernandes RM, Bialy LM, Vandermeer B, Tjosvold L, Plint AC, Patel H, Johnson DW, Klassen TP, Hartling L. Glucocorticoids for acute viral bronchiolitis in infants and young children. Cochrane Database Syst Rev. 2013 Jun 4;2013(6):CD004878. doi: 10.1002/14651858.CD004878.pub4. PMID: 23733383; PMCID: PMC6956441.
  20. 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 Emergency Research Canada (PERC). Epinephrine and dexamethasone in children with bronchiolitis. N Engl J Med. 2009 May 14;360(20):2079-89. doi: 10.1056/NEJMoa0900544. PMID: 19439742.
  21. Spurling GK, Doust J, Del Mar CB, Eriksson L. Antibiotics for bronchiolitis in children. Cochrane Database Syst Rev. 2011 Jun 15;(6):CD005189. doi: 10.1002/14651858.CD005189.pub3. Update in: Cochrane Database Syst Rev. 2014;10:CD005189. PMID: 21678346.
  22. Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP. Nebulised hypertonic saline solution for acute bronchiolitis in infants. Cochrane Database Syst Rev. 2013 Jul 31;(7):CD006458. doi: 10.1002/14651858.CD006458.pub3. Update in: Cochrane Database Syst Rev. 2017 Dec 21;12 :CD006458. PMID: 23900970.

Figures:

Similar Articles

Recently Viewed

  • Sites and Zones of Maximum Reactivity of the most Stable Structure of the Receptor-binding Domain of Wild-type SARS-CoV-2 Spike Protein: A Quantum Density Functional Theory Study
    Ernesto López-Chávez*, Alberto García-Quiroz, Yesica Antonia Peña-Castañeda, José Antonio Irán Díaz-Góngora, José Alberto Mendoza-Espinosa, J Antonio López-Barrera and Fray de Landa Castillo-Alvarado Ernesto López-Chávez*, Alberto García-Quiroz, Yesica Antonia Peña-Castañeda, José Antonio Irán Díaz-Góngora, José Alberto Mendoza-Espinosa, J Antonio López-Barrera, Fray de Landa Castillo-Alvarado. Sites and Zones of Maximum Reactivity of the most Stable Structure of the Receptor-binding Domain of Wild-type SARS-CoV-2 Spike Protein: A Quantum Density Functional Theory Study. J Clin Intensive Care Med. 2024: doi: 10.29328/journal.jcicm.1001047; 9: 008-016
  • Peripheral perfusion index in critically ill COVID-19 and its association with multiorgan dysfunction
    Cornu Matias German*, Tonelier Matias, Roel Pedro, Sanhueza Laura, Orozco Sergio Martin, Sepulveda Mariana Elizabet, Svampa Silvana Enrica and Arana Osorio Erick and Martinuzzi Andres Luciano Nicolas Cornu Matias German*, Tonelier Matias, Roel Pedro, Sanhueza Laura, Orozco Sergio Martin, Sepulveda Mariana Elizabet, Svampa Silvana Enrica, Arana Osorio Erick and Martinuzzi Andres Luciano Nicolas. Peripheral perfusion index in critically ill COVID-19 and its association with multiorgan dysfunction. J Clin Intensive Care Med. 2023: doi: 10.29328/journal.jcicm.1001043; 8: 004-013
  • Higher venom-specific IgE levels differentiate children with previous local large reactions from children with previous systemic reactions of different severity
    Pastorello Elide Anna*, Borgonovo Linda, Piantanida Marta, Schroeder Jan Walter, Pravettoni Valerio, Pastori Stefano, Bilo’ Maria Beatrice, Toniato Andrea, Aversano Maria Gloria, Farioli Laura, Nichelatti Michele and Preziosi Donatella Pastorello Elide Anna*,Borgonovo Linda,Piantanida Marta,Schroeder Jan Walter,Pravettoni Valerio,Pastori Stefano,Bilo’ Maria Beatrice,Toniato Andrea,Aversano Maria Gloria,Farioli Laura,Nichelatti Michele,Preziosi Donatella. Higher venom-specific IgE levels differentiate children with previous local large reactions from children with previous systemic reactions of different severity. Arch Asthma Allergy Immunol. 2021: doi: 10.29328/journal.aaai.1001025; 5: 017-021
  • Buffer Solutions of known Ionic Strength
    Víctor Cerdà* and Piyawan Phansi Víctor Cerdà*, Piyawan Phansi. Buffer Solutions of known Ionic Strength. Ann Adv Chem. 2023: doi: 10.29328/journal.aac.1001043; 7: 051-056
  • Validation of HPLC-UV method for determination of amoxicillin Trihydrate in capsule
    Sendanyoye Marcel*, Uwambajineza Tito, Ineza Ines and Nahimana Jean Pierre Sendanyoye Marcel*,Uwambajineza Tito,Ineza Ines,Nahimana Jean Pierre . Validation of HPLC-UV method for determination of amoxicillin Trihydrate in capsule. Ann Adv Chem. 2018: doi: 10.29328/journal.aac.1001014; 2: 055-072

Read More

Most Viewed

Read More

Help ?