Related Experiment Video
Updated: May 5, 2026
Surgical Treatment of an Endolymphatic Sac Tumor
Published on: May 26, 2023
Findings From Long-Term Follow-up in Children Hospitalized for Bronchiolitis in Pisa: Is It Time for a Standardized
F Abbate1,2, Y Biagini1,2, F Wiedemann1,2
1Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Insights
Infants hospitalized with bronchiolitis face increased risks of developing wheezing and asthma. Long-term follow-up is crucial for early detection and management of these respiratory conditions.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Epidemiology
Background:
- Bronchiolitis in infancy is linked to increased risk of later wheezing and asthma.
- The precise role of early bronchiolitis in respiratory sequelae requires further elucidation.
Purpose of the Study:
- To investigate the long-term respiratory outcomes in children previously hospitalized with bronchiolitis.
- To assess the necessity of standardized follow-up protocols for these patients.
Main Methods:
- A cohort of 102 children hospitalized for bronchiolitis between 2010-2019 underwent follow-up.
- Assessments included questionnaires, clinical exams, spirometry, and bronchodilator testing.
- Data on hospitalization treatments were analyzed, considering the 2014 Italian guidelines.
Main Results:
- 54% of patients developed wheezing, 12% were diagnosed with asthma, and 19% experienced exertional dyspnea.
- Risk factors included tobacco smoke exposure, family history of asthma, and allergies.
- Post-2014 guideline treatment showed increased HFNC and saline use, but reduced corticosteroids, with higher wheezing incidence.
Conclusions:
- Over half of infants hospitalized for bronchiolitis develop subsequent wheezing and/or asthma.
- These findings highlight the importance of long-term monitoring for early intervention and prevention of respiratory complications.
Background:
Children with bronchiolitis in early life are at increased risk of wheezing and asthma in the following years, though its exact role in these respiratory sequelae remains unclear.
Objectives:
This study aimed to determine the long-term outcomes of children previously hospitalized with bronchiolitis and to evaluate the need for a standardized follow-up in the following years.
Methods:
Among 346 patients hospitalized for bronchiolitis at the Pediatrics Unit of the University Hospital of Pisa between 2010 and 2019, 234 were reached by phone and 102 agreed to participate to our follow-up protocol. We excluded patients with missing records or who disagreed to participate to our study. Patients were assessed by an anamnestic questionnaire, clinical examination, spirometry test and bronchodilator reversibility test when needed. Data on treatment approaches during hospitalization were recorded and analyzed considering that the Italian guidelines for the management of bronchiolitis were published in 2014.
Results:
In the study cohort, 102 patients were included (57 males, mean age 8.5 years), the mean age at hospitalization was 3.6 months and disease severity was mild, moderate, and severe in 44%, 49%, and 7% of cases, respectively. As for long-term sequelae, 54% developed wheezing (mean onset at 1.6 years), 12% were diagnosed with asthma, and 19% reported exertional dyspnea. Risk factors for respiratory sequelae included tobacco smoke exposure, family history of asthma, and personal history of allergy (p < 0.05). No associations were found with gender, prematurity, pathogens, age at evaluation, or BMI. Of 88 patients undergoing spirometry, six showed pathological FEV1, and 16 had a positive bronchodilator test. Patients treated after the publication of the 2014 Italian Guidelines received more HFNC and nebulized hypertonic saline but fewer corticosteroids. Wheezing incidence was higher after 2014 (63% vs. 42%), while asthma rates were unchanged.
Conclusions:
Over half of patients hospitalized for bronchiolitis in the first year of life developed wheezing and/or asthma during follow-up. These findings support long-term follow-up for early detection and management of respiratory sequelae to prevent further complications.
Related Concept Videos
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:26COPD: Management Using Bronchodilators and Corticosteroids
01:30Pneumonia III: Complications and Assessment
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices 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....
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features