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Latest & greatest articles for bronchiolitis
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Bronchiolitis is mainly caused by the respiratory syncytial virus (RSV). The virus travels down to the bronchioles in the lungs causing them to become inflamed making it difficult to breath.
Almost every child will be infected with RSV by the time they reach two years. Adults can also contract the virus, typically during winter months.
In mild cases bronchiolitis will clear up without treatment. The virus that causes bronchiolitis travels through tiny droplets of liquid and can be passed through the air or contracted by touching infected surfaces.
Symptoms include: Sore throat, dry cough, blocked nose and aches and pains throughout the body.
Although there is no cure for chronic bronchiolitis research and clinical studies on bronchiolitis suggest that some lifestyle changes can ease symptoms: avoid smoking, eat a healthy diet and maintain regular exercise. In extreme cases steroids can be prescribed to help minimise inflammation.
Read more on medications used to treat bronchiolitis and the causes of the virus.
WITHDRAWN: Inhaled corticosteroids during acute bronchiolitis in the prevention of post-bronchiolitic wheezing. Acute bronchiolitis in infants and young children is associated with long-term airway disease also known as post-bronchiolitic wheezing. Two major hypotheses have been proposed to explain the association between bronchiolitis and PBW. The first hypothesis considers bronchiolitis to be the first manifestation of recurrent wheezing in infants and children who are susceptible (...) to obstructive airway disease. The second hypothesis suggests that the infection and concomitant inflammatory reaction in the acute phase leads to airway epithelium injury resulting in long-term obstructive airway disease. In line with the latter hypothesis, corticosteroids may have a beneficial effect on the prevention of post-bronchiolitic wheezing.The objective of this review was to evaluate the effect of inhaled corticosteroids, started during the acute phase of bronchiolitis, on the prevention of post
Steam inhalation or humidified oxygen for acute bronchiolitis in children up to three years of age. Acute bronchiolitis is a common respiratory infection and a major cause of morbidity in young children. It is treated with bronchodilators (for example, salbutamol), corticosteroids or humidified air (steam inhalation or cool mist). Steam inhalation is preferred in low-income countries as it is inexpensive and easily available. It is thought to act as a secretolytic agent to lighten secretions (...) (1981 to March 2010), AMED (1985 to March 2010), Web of Science (2000 to March 2010) and LILACS (1982 to March 2010).Randomised controlled trials involving children up to three years old with bronchiolitis comparing steam inhalation (or cool mist) or humidified oxygen against bronchodilators, corticosteroids or placebo; alone or in combination.Two review authors independently assessed trial quality and extracted data.Only one study (156 children aged between seven weeks and 24 months with signs
Steroids and bronchodilators for acute bronchiolitis in the first two years of life: systematic review and meta-analysis. To evaluate and compare the efficacy and safety of bronchodilators and steroids, alone or combined, for the acute management of bronchiolitis in children aged less than 2 years.Systematic review and meta-analysis.Medline, Embase, Central, Scopus, PubMed, LILACS, IranMedEx, conference proceedings, and trial registers. Inclusion criteria Randomised controlled trials (...) of children aged 24 months or less with a first episode of bronchiolitis with wheezing comparing any bronchodilator or steroid, alone or combined, with placebo or another intervention (other bronchodilator, other steroid, standard care).Two reviewers assessed studies for inclusion and risk of bias and extracted data. Primary outcomes were selected by clinicians a priori based on clinical relevance: rate of admission for outpatients (day 1 and up to day 7) and length of stay for inpatients. Direct meta
Palivizumab for immunoprophylaxis of respiratory syncitial virus (RSV) bronchiolitis in high-risk infants and young children: a systematic review and additional economic modelling of subgroup analyses Palivizumab for immunoprophylaxis of respiratory syncytial virus (RSV) bronchiolitis in high-risk infants and young children: a systematic review and additional economic modelling of subgroup analyses Palivizumab for immunoprophylaxis of respiratory syncytial virus (RSV) bronchiolitis in high-risk (...) infants and young children: a systematic review and additional economic modelling of subgroup analyses Wang D, Bayliss S, Meads C Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Wang D, Bayliss S, Meads C. Palivizumab for immunoprophylaxis of respiratory syncytial virus (RSV) bronchiolitis in high-risk infants and young children: a systematic
Nebulized 5% or 3% hypertonic or 0.9% saline for treating acute bronchiolitis in infants To compare the efficacy and safety of 5%, 3%, and 0.9% saline solution for treating acute bronchiolitis in the prehospital setting.This was a double-blind trial including consecutive infants aged <18 months treated in an urban urgent care setting. A total of 165 patients were randomized to receive nebulized 5%, 3%, or 0.9% (normal) saline with epinephrine every 4 hours. The primary efficacy outcome (...) was bronchiolitis severity score improvement at 48 hours (chi2 analysis). Scores and oxygen saturation immediately before and after each treatment were recorded to assess safety.A total of 187 previously healthy infants (median age, 3.1 months) diagnosed with bronchiolitis were enrolled. Positivity for respiratory syncytial virus was similar in the 3 treatment groups (mean, 56%). At 48 hours, the mean severity score for the 5% saline group was 3.69+/-1.09, and that for the 0.9% saline group was 4.12+/-1.11 (P
Survival after bronchiolitis obliterans syndrome among bilateral lung transplant recipients Despite the importance of bronchiolitis obliterans syndrome (BOS) in lung transplantation, little is known regarding the factors that influence survival after the onset of this condition, particularly among bilateral transplant recipients.To identify factors that influence survival after the onset of BOS among bilateral lung transplant recipients.The effect of demographic or clinical factors, occurring
A randomized trial of nebulized 3% hypertonic saline with epinephrine in the treatment of acute bronchiolitis in the emergency department To determine whether nebulized 3% hypertonic saline with epinephrine is more effective than nebulized 0.9% saline with epinephrine in the treatment of bronchiolitis in the emergency department.Randomized, double-blind, controlled trial.Single-center urban pediatric emergency department.Infants younger than 12 months with mild to moderate (...) baseline characteristics. The RACS from baseline to 120 minutes demonstrated no improvement in respiratory distress in the hypertonic saline group compared with the normal saline control group. The change in oxygen saturation in the hypertonic saline group was not significant when compared with the control group. Rates of admission and return to the emergency department were not different between the 2 groups.In the treatment of acute bronchiolitis, hypertonic saline and epinephrine did not improve
WITHDRAWN. Surfactant therapy for bronchiolitis in critically ill infants. Viral bronchiolitis is a common cause of respiratory failure in infants and children, and accounts for a significant portion of intensive care unit (ICU) admissions during seasonal epidemics. Currently there is no evidence to support the use of anything but supportive care for this disease. Surfactant is a potentially promising therapy; alterations in its composition have been described in bronchiolitis, and it may play (...) a role in the host immunity for this disease.To assess the efficacy of exogenous surfactant for the treatment of bronchiolitis in mechanically ventilated infants and children.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2006, issue 1) which contains the Acute Respiratory Infections Group's Specialized Register; MEDLINE (1966 to Week 1, February 2006); and EMBASE (1990 to September 2005).Randomised controlled trials (RCTs) comparing surfactant
The Effectiveness of Dexamethasone as Adjunctive Therapy to Racemic Epinephrine for a Pediatric Patient With Bronchiolitis "The Effectiveness of Dexamethasone as Adjunctive Therapy to Racemic Ep" by Michelle M. Harsono < > > > > > Title Author Date of Graduation 8-14-2010 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies First Advisor Rob Rosenow, PharmD, OD Second Advisor Annjanette Sommers MS, PAC Rights . Abstract Background: Bronchiolitis is a lower (...) respiratory tract infection that is most common in the pediatric population, and is the major cause of hospitalizations for patients in their first year of life. Despite the prevalence of this disease, a consensus for optimal treatment is elusive. Although numerous studies have addressed dexamethasone or epinephrine alone, the combination is not well established. The optimal therapeutic management of bronchiolitis is still controversial. The objective of this literature review is to determine
CPG on Acute Bronchiolitis Clinical Practice Guideline on Acute Bronchiolitis CLINICAL PRACTICE GUIDELINES IN THE SPANISH NATIONAL HEALTHCARE SYSTEM MINISTRY FOR HEALTH AND SOCIAL POLICYIt has been 5 years since the publication of this Clinical Practice Guideline and it is subject to updating. Clinical Practice Guideline on Acute Bronchiolitis CLINICAL PRACTICE GUIDELINES IN THE SPANISH NATIONAL HEALTHCARE SYSTEM MINISTRY FOR HEALTH AND SOCIAL POLICY It has been 5 years since the publication (...) been funded via an agreement entered into by the Carlos III Health Institute, an autonomous body within the Spanish Ministry for Science and Innovation, and the Catalan Agency for Health Technology Assessment, within the framework for cooperation established in the Quality Plan for the Spanish National Healthcare System of the Spanish Ministry for Health and Social Policy. This guideline must be cited: Working Group of the Clinical Practice Guideline on Acute Bronchiolitis; Sant Joan de Déu
Bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation. With improvements in supportive care, both long-term survival following allogeneic hematopoietic stem cell transplantations (HSCTs) and the indications for this procedure have increased. As a result, the number of patients living with long-term toxic effects due to HSCT has increased. A once rare condition of the donor immune cells attacking healthy host tissues, termed chronic graft-vs-host disease, has become (...) a more common phenomenon. When chronic graft-vs-host disease affects the lung tissue, bronchiolitis obliterans syndrome ensues. Recent data suggest that bronchiolitis obliterans syndrome may affect up to 6% of HSCT recipients and dramatically alters survival, with overall survival of only 13% at 5 years. These statistics have not improved since the first presentation of this disease over 20 years ago. Challenges to the progress of medical management of bronchiolitis obliterans syndrome include
Nebulised hypertonic saline significantly decreases length of hospital stay and reduces symptoms in children with bronchiolitis BestBets: Nebulised hypertonic saline significantly decreases length of hospital stay and reduces symptoms in children with bronchiolitis Nebulised hypertonic saline significantly decreases length of hospital stay and reduces symptoms in children with bronchiolitis Report By: Daniel Horner - ST3 Emergency Medicine / Critical Care Search checked by Rachel Jenner (...) - Paediatric Emergency Medicine Consultant Institution: Booth Hall Childrens Hospital Date Submitted: 31st January 2007 Date Completed: 3rd July 2009 Last Modified: 3rd July 2009 Status: Green (complete) Three Part Question In [children Clinical Scenario A 3 month old books in to the Emergency Department with a 4 day history of a coryzal illness followed by breathing difficulties and decreased oral intake. It is December. Inwardly you sigh heavily, berating the fact that bronchiolitis season is upon you
Is continuous positive airway pressure effective in bronchiolitis? BestBets: Is continuous positive airway pressure effective in bronchiolitis? Is continuous positive airway pressure effective in bronchiolitis? Report By: V Palanivel, M A Anjay - Paediatric Registrars Institution: Addenbrooke's Hospital, Cambridge and James Paget University Hospitals NHS Foundation Trust, Gorleston, Great Yarmouth Date Submitted: 27th February 2004 Date Completed: 5th May 2009 Last Modified: 5th May 2009 Status (...) : Green (complete) Three Part Question In [infants with worsening bronchiolitis] does [nasal continuous positive airway pressure compared with the standard management of oxygen and supportive care] improve [clinical status and/or avoid mechanical ventilation]? Clinical Scenario A 3-month-old boy is admitted to the paediatric ward with bronchiolitis. He is initially managed with oxygen, nursing care and intravenous fluids. However, his respiratory distress worsens a few hours after admission
Epinephrine and dexamethasone in children with bronchiolitis. Although numerous studies have explored the benefit of using nebulized epinephrine or corticosteroids alone to treat infants with bronchiolitis, the effectiveness of combining these medications is not well established.We conducted a multicenter, double-blind, placebo-controlled trial in which 800 infants (6 weeks to 12 months of age) with bronchiolitis who were seen in the pediatric emergency department were randomly assigned to one (...) to the hospital. In the unadjusted analysis, only the infants in the epinephrine-dexamethasone group were significantly less likely than those in the placebo group to be admitted by day 7 (relative risk, 0.65; 95% confidence interval, 0.45 to 0.95, P=0.02). However, with adjustment for multiple comparisons, this result was rendered insignificant (P=0.07). There were no serious adverse events.Among infants with bronchiolitis treated in the emergency department, combined therapy with dexamethasone
Nebulised hypertonic saline effective for acute bronchiolitis in infants PEARLS Practical Evidence About Real Life Situations PEARLS are succinct summaries of Cochrane Systematic Reviews for primary care practitioners. They Nebulised hypertonic saline effective for acute bronchiolitis in infants Clinical question How effective is nebulised hypertonic saline solution in infants with acute viral bronchiolitis? Bottom line Compared to treatment with nebulised 0.9% saline, nebulised 3% saline (...) produced a 25.9% reduction (0.94 days) in the mean length of hospital stay among infants hospitalised with viral bronchiolitis. The 3% saline group also had a significantly lower post-inhalation clinical score than the 0.9% saline group in the first 3 days of treatment. The effect of nebulised hypertonic saline in improving clinical score was greater among outpatients than inpatients. No adverse events related to the 3% saline inhalations were reported. Caveat Three trials did not use analysis
Descriptive epidemiological features of bronchiolitis in a population-based cohort The goal was to investigate the epidemiological features of incident bronchiolitis by using a population-based infant cohort.Outpatient and inpatient health records were used to identify incident bronchiolitis cases among 93,058 singleton infants born in the Georgia Air Basin between 1999 and 2002. Additional health-related databases were linked to provide data on sociodemographic variables, maternal (...) characteristics, and birth outcome measures.From 1999 to 2002, bronchiolitis accounted for 12,474 incident health care encounters (inpatient or outpatient contacts) during the first year of life (134.2 cases per 1000 person-years). A total of 1588 hospitalized bronchiolitis cases were identified (17.1 cases per 1000 person-years). Adjusted Cox proportional-hazard analyses for both case definitions indicated an increased risk of incident bronchiolitis in the first year of life (follow-up period: 2-12 months