ウイルス性肺炎

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.

Lancet (London, England)

|August 24, 2016

まとめ

乳児のウイルス性肺炎は臨床診断が必要で,酸素と水分を中心にサポートケアを行う必要があります. ブロンコディラータとコルチコステロイドは,最初のエピソードに対して証明された利点を提供していません.

科学分野:

小児科
感染症
呼吸器医学

背景:

ウイルス性支氣管炎は,乳児および幼い子供の呼吸器疾患である.
体系的なレビューと臨床実践ガイドラインにまとめられた重要な研究が存在します.
懸念事項には,この状態に関連した罹病率と医療費が含まれます.

研究の目的:

ウイルス性支氣管炎の診断と管理のための現在の証拠とガイドラインをレビューする.
様々な治療法の有効性を評価する.
小児の呼吸器感染症の臨床診察を参考にする.

主な方法:

既存の研究と臨床実践のガイドラインを体系的に検討する.
診断検査,サポートケア,薬理学的介入に関する証拠の分析
重篤な症例における高度呼吸器支援に関するデータの評価

主要な成果:

典型的なウイルス性ブロンキオ炎の場合,臨床診断が推奨されます.
酸素と水分を中心にサポート管理を行うのが標準です.
支柱管拡張剤とコルチコステロイドは,第1回支柱管炎の治療に効果を示さない.
塩分濃度の高さの証拠はまだ進化しています
高流量鼻カヌーラとCPAPは重篤な症例に役立ちますが,データは限られています.

結論:

ウイルス性支氣管炎の診断は臨床的評価に依存し,診断検査を最小限にします.
サポートケアは経営の礎です
現状の証拠は, bronchodilatorsやコルチコステロイドの日常的な使用を支持していません.
ハイパートニック塩溶液や呼吸支援などの治療にはさらなる研究が必要です

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