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Published on: January 21, 2018
Bronchiolitis
Thomas Bourke1, Michael Shields
1Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, UK.
Insights
This systematic review examines interventions for infant bronchiolitis, a common respiratory infection. It found 59 studies on treatments, prophylactic measures, and hospital transmission prevention, evaluating their effectiveness and safety.
Area of Science:
- Pediatrics
- Infectious Diseases
- Respiratory Medicine
Background:
- Bronchiolitis is the most frequent lower respiratory tract infection in infants.
- It exhibits a distinct seasonal incidence, peaking in winter or rainy seasons.
- Bronchiolitis is a primary cause for pediatric hospitalizations.
Purpose of the Study:
- To systematically review the effectiveness of prophylactic interventions for high-risk children with bronchiolitis.
- To assess measures for preventing bronchiolitis transmission within hospital settings.
- To evaluate the efficacy and safety of various treatments for bronchiolitis.
Main Methods:
- A systematic review methodology was employed.
- Searches were conducted across major databases (Medline, Embase, Cochrane Library) up to July 2010.
- Inclusion criteria encompassed systematic reviews, RCTs, and observational studies; harms alerts were also considered.
Main Results:
- A total of 59 relevant studies met the inclusion criteria.
- The GRADE system was utilized to evaluate the quality of evidence for interventions.
- Data on a wide range of interventions were compiled and analyzed.
Conclusions:
- The review synthesizes evidence on the effectiveness and safety of numerous interventions for bronchiolitis.
- Interventions discussed include antibiotics, bronchodilators, corticosteroids, and nursing protocols.
- The findings provide a comprehensive overview for managing infant bronchiolitis.
Introduction:
Bronchiolitis is the most common lower respiratory tract infection in infants, occurring in a seasonal pattern, with highest incidence in the winter in temperate climates and in the rainy season in warmer countries. Bronchiolitis is a common reason for attendance at and admission to hospital.
Methods And Outcomes:
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of prophylactic interventions for bronchiolitis in high-risk children? What are the effects of measures to prevent transmission of bronchiolitis in hospital? What are the effects of treatments for children with bronchiolitis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
Results:
We found 59 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
Conclusions:
In this systematic review we present information relating to the effectiveness and safety of the following interventions: antibiotics, bronchodilators (oral, inhaled salbutamol, inhaled adrenaline [epinephrine], hypertonic saline), chest physiotherapy, continuous positive airway pressure, corticosteroids, fluid management, heliox, montelukast, nasal decongestants, nursing interventions (cohort segregation, hand washing, gowns, masks, gloves, and goggles), oxygen, respiratory syncytial virus immunoglobulins, pooled immunoglobulins, or palivizumab (monoclonal antibody), ribavirin, or surfactants.
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