[Acute viral bronchiolitis - still subject for controversy]

OBJECTIVES: The authors review the current literature on acute viral bronchiolitis discussing the points still subject to controversy in regard to its treatment. At the same time, a personal point of view on the management of this disorder based on the authorś experience is also expressed.METHODS: The main published papers from the last twenty years were selected from a Medline database search.RESULTS: Acute viral bronchiolitis is an acute viral illness of the lower respiratory tract occuring most frequently during the first year of life. In spite of its important prevalence and the relative risk that this disorder may pose to pediatric patients there is still a lot of controversy in regard to its treatment. However, it seems of paramount importance to mainten an adequate hidration, to prevent cross infection and to offer supplementary oxygen. There are many doubts as to the role of bronchodilators and antivirals such as ribavirin. There are new hopes with the introduction of specific immunoglobulin, mostly as a prophylactic role in respiratory syncycial virus infection in at risk populations. Steroids seem to have no place in the treatment at least in the acute stages of the disease. CONCLUSIONS: Acute viral bronchiolitis is still a disorder which lacks a specific treatment. The routine treatment has little changed for the last 30 years and there is controversy in regard to its management in the different clinical centers.