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La bronquiolitis por virus

Todd A Florin1, Amy C Plint2, Joseph J Zorc3

  • 1Division of Pediatric Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

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|August 24, 2016
PubMed
Resumen
Este resumen es generado por máquina.

La bronquiolitis viral en bebés requiere un diagnóstico clínico, con atención de apoyo enfocada en la oxigenación y la hidratación. Los broncodilatadores y los corticosteroides no ofrecen ningún beneficio comprobado para los primeros episodios.

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Área de la Ciencia:

  • Pediatría
  • Enfermedades infecciosas
  • Medicina de las vías respiratorias

Sus antecedentes:

  • La bronquiolitis viral es una enfermedad respiratoria frecuente en bebés y niños pequeños.
  • Existen investigaciones significativas, resumidas en revisiones sistemáticas y guías de práctica clínica.
  • Las preocupaciones incluyen la morbilidad y los costos de atención médica asociados con la condición.

Objetivo del estudio:

  • Revisar la evidencia y las directrices actuales para el diagnóstico y el tratamiento de la bronquiolitis viral.
  • Evaluar la eficacia de las distintas modalidades de tratamiento.
  • Informar la práctica clínica para las infecciones respiratorias pediátricas.

Principales métodos:

  • Revisión sistemática de las directrices de investigación y práctica clínica existentes.
  • Análisis de la evidencia con respecto a las pruebas de diagnóstico, la atención de apoyo y las intervenciones farmacológicas.
  • Evaluación de los datos sobre soporte respiratorio avanzado para casos graves.

Principales resultados:

  • Se recomienda el diagnóstico clínico para las presentaciones típicas de bronquiolitis viral.
  • El manejo de apoyo centrado en la oxigenación y la hidratación es estándar.
  • Los broncodilatadores y los corticosteroides no muestran ningún beneficio en el primer episodio de bronquiolitis.
  • La evidencia para la solución salina hipertónica aún está evolucionando.
  • La cánula nasal de alto flujo y la CPAP pueden ayudar en casos graves, pero los datos son limitados.

Conclusiones:

  • El diagnóstico de la bronquiolitis viral se basa en la evaluación clínica, minimizando las pruebas de diagnóstico.
  • La atención de apoyo es la piedra angular de la gestión.
  • La evidencia actual no apoya el uso rutinario de broncodilatadores o corticosteroides.
  • Se necesita más investigación para tratamientos como la solución salina hipertónica y el soporte respiratorio avanzado.