Related Experiment Video
Updated: Sep 14, 2025
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Australasian Bronchiolitis Guideline: 2025 Update
Meredith L Borland1,2, Kate Loveys3, Franz E Babl4,5,6
1Emergency Department, Perth Children's Hospital, Perth, Western Australia, Australia.
Insights
This updated guideline offers evidence-based management for infant bronchiolitis in Australian and New Zealand emergency departments and hospitals. It includes refined clinical features, new risk factors, and updated treatment recommendations for better patient care.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Practice Guidelines
Background:
- Bronchiolitis is a common cause of infant hospital admissions.
- Previous guidelines were published in 2016.
- Updated evidence is crucial for optimal management.
Purpose of the Study:
- To provide updated, evidence-based clinical guidance for managing infant bronchiolitis.
- To address emergency, general pediatric, and intensive care unit settings.
- To cover Australia and Aotearoa New Zealand.
Main Methods:
- Systematic review and evidence appraisal from 2000 to 2024.
- Addressed 41 clinical questions (30 updated, 11 new).
- Recommendations developed using GRADE methodology and external consultation.
Main Results:
- 431 studies informed 41 recommendations.
- Key updates include refined clinical features and new risk factors for severity.
- New guidance on biomarkers, glucocorticoids, oxygen targets, and respiratory support therapies.
Conclusions:
- The updated guideline offers the latest evidence-based management for infant bronchiolitis.
- It supports clinicians in Australasian settings.
- Aims to improve care for infants requiring hospital admission.
Aim:
To provide updated evidence-based clinical guidance in the management of infants with bronchiolitis presenting to emergency departments (EDs), general paediatric, or intensive care units (ICUs) in Australia and Aotearoa New Zealand (AoNZ) following the first publication in 2016.
Method:
The Paediatric Research in Emergency Departments International Collaborative (PREDICT) network guideline working group appraised, summarised, and updated evidence from 1 January 2000 to 24 January 2024 addressing 41 questions (30 from the 2016 guideline and 11 new questions for 2025). Recommendations were developed using GRADE methodology and revised after a period of external consultation.
Results:
The literature search identified 26 467 citations with 431 included in 41 recommendations providing 11 new and 7 key updates. The key changes included: (i) refinement of the clinical features of bronchiolitis, (ii) addition of new risk factors for severity of illness, (iii) advice on the role of biomarkers for unexpected deterioration or admission to ICU, (iv) guidance on glucocorticoids in SARS-CoV-2 co-infection, (v) guidance on combined glucocorticoids/inhaled epinephrine in severe bronchiolitis requiring ICU level care, (vi) refinement of oxygen saturation targets, (vii) guidance on humidified high flow therapy and continuous positive airway pressure, (viii) recommendation on use of RSV prevention therapies/immunisations for babies and mothers.
Conclusion:
The updated Australasian Bronchiolitis Guideline provides clinicians across Australasian settings with the latest evidence-based guidance on the management of the commonest condition in infancy requiring hospital admission.
Related Concept Videos
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:30Asthma-IV: Nursing Management
First, in...
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....