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Australasian bronchiolitis guideline
Sharon O'Brien1,2, Meredith L Borland1,3, Elizabeth Cotterell4
1Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
Insights
This study developed an evidence-based guideline to standardize bronchiolitis management in infants across Australasia. The guideline aims to improve consistency in treating this common respiratory illness in young children.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Evidence-Based Medicine
Background:
- Bronchiolitis is a frequent lower respiratory tract illness in infants under 12 months.
- Significant variations in clinical practice exist for bronchiolitis management.
- There is a need for consistent, evidence-based treatment protocols.
Purpose of the Study:
- To develop an evidence-based clinical practice guideline for bronchiolitis management.
- To improve the consistency and alignment of care for infants with bronchiolitis in Australasia.
- To provide clear guidance for healthcare professionals managing bronchiolitis.
Main Methods:
- A multidisciplinary committee with geographical representation developed the guideline.
- Literature search conducted from 2000-2015, focusing on PICO questions.
- Evidence graded using National Health and Medical Research Council (NHMRC) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodologies.
- Consensus achieved through nominal group technique; guideline reviewed and endorsed by key pediatric bodies.
Main Results:
- A user-friendly clinical guideline with evidence summaries and tables was created.
- The NHMRC and GRADE frameworks ensured a systematic and transparent literature review.
- The guideline is tailored for the Australasian clinical setting.
Conclusions:
- This is the first comprehensive Australasian guideline for acute pediatric care.
- Provides clear management recommendations for most bronchiolitis cases in emergency departments and general pediatric wards.
- Aims to standardize and enhance the quality of care for infants with bronchiolitis.
Aim:
Bronchiolitis is the most common lower respiratory tract disorder in infants aged less than 12 months, and research has demonstrated that there is substantial variation in practice patterns despite treatment being well defined. In order to align and improve the consistency of the management of bronchiolitis, an evidence-based guideline was developed for the Australasian population.
Methods:
The guideline development committee included representation from emergency and paediatric specialty medical and nursing personnel in addition to geographical representation across Australia and New Zealand - rural, remote and metropolitan. Formulation of the guideline included identification of population, intervention, comparator, outcomes and time questions and was associated with an extensive literature search from 2000 to 2015. Evidence was summarised and graded using the National Health and Medical Research Council and Grading of Recommendations Assessment, Development and Evaluation methodology, and consensus within the guideline group was sought using nominal group technique principles to formulate the clinical practice recommendations. The guideline was reviewed and endorsed by key paediatric health bodies.
Results:
The guideline consists of a usable clinical interface for bedside functionality supported by evidence summary and tables. The Grading of Recommendations Assessment, Development and Evaluation and National Health and Medical Research Council processes provided a systematic and transparent process to review and assess the literature, resulting in a guideline that is relevant to the management of bronchiolitis in the Australasian setting.
Conclusion:
This is the first robust Australasian acute paediatric guideline and provides clear guidance for the management of the vast majority of patients seen in Australasian emergency departments and general paediatric wards with bronchiolitis.
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