Recent advances in management of bronchiolitis
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Published on: November 4, 2010
Nishant Verma1, Rakesh Lodha, S K Kabra
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India. Correspondence to: Dr SK Kabra, Department of Pediatrics, AIIMS, New Delhi. skkabra@hotmail.com.
Insights
Supportive care for infant bronchiolitis, focusing on oxygenation and hydration, is key. Bronchodilators and corticosteroids are not recommended, but some novel therapies like hypertonic saline show promise.
Area of Science:
- Pediatrics
- Respiratory Medicine
Background:
- Bronchiolitis is a leading cause of infant hospitalizations.
- Managing infant bronchiolitis presents significant challenges for pediatricians.
- The efficacy of current bronchiolitis interventions is not well-established.
Purpose of the Study:
- To assess evidence for infant bronchiolitis treatments and prevention.
- To offer practical guidelines for managing pediatric bronchiolitis.
Main Methods:
- Conducted a PubMed and Cochrane Database search for bronchiolitis articles.
- Focused on diagnosis, treatment, and prevention in children.
- Extracted data from English-language studies published in the last 20 years.
Main Results:
- Supportive care (oxygenation, hydration) is the primary therapy for bronchiolitis.
- Pulse oximetry guides oxygen administration.
- Bronchodilators and corticosteroids lack proven efficacy and should be avoided.
Conclusions:
- While many novel therapies show limited benefit, hypertonic saline, surfactant, and CPAP demonstrate potential.
- Further research may clarify the role of these promising interventions.
Background:
Bronchiolitis is one of the major causes for hospital admissions in infants. Managing bronchiolitis, both in the outpatient and inpatient setting remains a challenge to the treating pediatrician. The effectiveness of various interventions used for infants with bronchiolitis remains unclear.
Need And Purpose:
To evaluate the evidence supporting the use of currently available treatment and preventive strategies for infants with bronchiolitis and to provide practical guidelines to the practitioners managing children with bronchiolitis.
Methods:
A search of articles published on bronchiolitis was performed using PubMed. The areas of focus were diagnosis, treatment and prevention of bronchiolitis in children. Relevant information was extracted from English language studies published over the last 20 years. In addition, the Cochrane Database of Systematic Reviews was searched.
Results And Conclusions:
Supportive care, comprising of taking care of oxygenation and hydration, remains the corner-stone of therapy in bronchiolitis. Pulse oximetry helps in guiding the need for oxygen administration. Several recent evidence-based reviews have suggested that bronchodilators or corticosteroids lack efficacy in bronchiolitis and should not be routinely used. A number of other novel therapies (such as nebulized hypertonic saline, heliox, CPAP, montelukast, surfactant, and inhaled furosemide) have been evaluated in clinical trials, and although most of them did not show any beneficial results, some like hypertonic saline, surfactant, CPAP have shown promising results.
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