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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.
Antibiotics for bronchiolitis in children. Bronchiolitis is a serious, potentially life-threatening respiratory illness commonly affecting young babies. It is most often caused by Respiratory Syncytial Virus (RSV). The diagnosis is usually made on clinical grounds (especially tachypnoea and wheezing in a child less than two years of age). Antibiotics are not recommended for bronchiolitis unless there is concern about complications such as secondary bacterial pneumonia. Despite (...) ).Types of studies: single or double blind randomised controlled trials comparing antibiotics to placebo in the treatment of bronchiolitis.children under the age of two years diagnosed with bronchiolitis using clinical criteria (including respiratory distress preceded by coryzal symptoms with or without fever). Types of interventions: oral, intravenous, intramuscular or inhaled antibiotics versus placebo. Types of outcome measures: primary clinical outcomes: time for the resolution of symptoms/signs
A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis. Bronchiolitis, the most common infection of the lower respiratory tract in infants, is a leading cause of hospitalization in childhood. Corticosteroids are commonly used to treat bronchiolitis, but evidence of their effectiveness is limited.We conducted a double-blind, randomized trial comparing a single dose of oral dexamethasone (1 mg per kilogram of body weight) with placebo in 600 children (age range, 2 to 12 (...) months) with a first episode of wheezing diagnosed in the emergency department as moderate-to-severe bronchiolitis (defined by a Respiratory Distress Assessment Instrument score > or =6). We enrolled patients at 20 emergency departments during the months of November through April over a 3-year period. The primary outcome was hospital admission after 4 hours of emergency department observation. The secondary outcome was the Respiratory Assessment Change Score (RACS). We also evaluated later outcomes
Clinical efficacy of moxifloxacin in the treatment of exacerbations of chronic bronchitis: a systematic review and meta-analysis Clinical efficacy of moxifloxacin in the treatment of exacerbations of chronic bronchitis: a systematic review and meta-analysis Clinical efficacy of moxifloxacin in the treatment of exacerbations of chronic bronchitis: a systematic review and meta-analysis Miravitlles M, Molina J, Brosa M CRD summary This review aimed to compare the clinical efficacy of moxifloxacin (...) to that of antibiotic regimens routinely used to treat exacerbations of chronic bronchitis. The authors concluded that the clinical success rate tends to be higher for moxifloxacin than for standard antibiotic treatments. However, methodological concerns, especially about the validity of the pooled estimate, suggest that the reliability of the authors conclusions is unclear. Authors' objectives To compare the clinical efficacy of moxifloxacin to that of antibiotic regimens routinely used to treat exacerbations
Efficacy of interventions for bronchiolitis in critically ill infants: A systematic review and meta-analysis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Bronchiolitis. Bronchiolitis is a distressing, potentially life-threatening respiratory condition that affects young babies. Around 2-3% of all infants younger than 1 year are admitted to hospital with bronchiolitis, usually during the seasonal epidemic. The majority of these infants are infected with respiratory syncytial virus and all have an intense inflammatory response in their airways. Although most infants recover, they have an increased risk of recurrent wheezing. Although bronchiolitis (...) is common, little is known about what causes infants to be susceptible. Diagnostic interventions have little effect on clinical outcome, and apart from supportive measures, there is no specific treatment. Bronchiolitis therefore presents an intriguing clinical conundrum and a major challenge to researchers. High quality clinical studies are needed to clarify assessment of disease severity and criteria for hospital admission, particularly the use of pulse oximetry and chest radiography. Careful mapping
Chinese medicinal herbs for acute bronchitis. Acute bronchitis is one of the most common diagnoses made by primary-care physicians. It is traditionally treated with antibiotics, (although the evidence for their effectiveness is weak and modest at best), and other even less effective treatments. Chinese medicinal herbs have been also used as treatment.This review aims to summarise the existing evidence on the comparative effectiveness and safety of Chinese medicinal herbs for treating (...) with placebo, antibiotics or other Western medicines for the treatment of uncomplicated acute bronchitis.At least two authors extracted data and assessed trial quality.Four trials reported the time to improvement of cough, fever, and rales associated with bronchitis and showed that patients treated with Chinese herbs had a shorter duration of signs and symptoms. Two trials reported the proportion of patients with improved signs and symptoms at follow up and showed that Chinese herbs were beneficial
Effects of N-acetylcysteine on outcomes in chronic obstructive pulmonary disease (Bronchitis Randomized on NAC Cost-Utility Study, BRONCUS): a randomised placebo-controlled trial. Increased oxidative stress is important in the pathogenesis of chronic obstructive pulmonary disease (COPD). We postulated that treatment with the antioxidant N-acetylcysteine would reduce the rate of lung-function decline, reduce yearly exacerbation rate, and improve outcomes.In a randomised placebo-controlled study
2005LancetControlled trial quality: predicted high
Is nasogastric fluid therapy a safe alternative to the i.v. route in infants with bronchiolitis? BestBets: Is nasogastric fluid therapy a safe alternative to the i.v. route in infants with bronchiolitis? Is nasogastric fluid therapy a safe alternative to the i.v. route in infants with bronchiolitis? Report By: Neil Kennedy - SpR Paediatrics Search checked by Nuala Flanagan - SpR Paediatrics Institution: Royal Belfast Hospital for Sick Children Date Submitted: 7th September 2004 Date Completed (...) : 10th March 2005 Last Modified: 10th March 2005 Status: Green (complete) Three Part Question In [infants with bronchiolitis who need maintenance or replacement fluid therapy] is [administration of fluid by NG tube compared to IV infusion] [cause more respiratory difficulty or electrolyte disturbance] Clinical Scenario It is mid-December. As a paediatric SHO working a busy evening shift in a district general hospital, you are called to re-site the iv cannula of an infant with bronchiolitis
Are methylxanthines effective in preventing or reducing apnoeic spells in infants with bronchiolitis? BestBets: Are methylxanthines effective in preventing or reducing apnoeic spells in infants with bronchiolitis? Are methylxanthines effective in preventing or reducing apnoeic spells in infants with bronchiolitis? Report By: Pavanasam Ramesh, Martin Samuels - Staff Grade and Consultant Paediatrician respectively Search checked by Bob Phillips - Section Editor Archimedes, Archives of Disease (...) in Childhood Institution: University Hospital of North Staffordshire Date Submitted: 10th March 2005 Date Completed: 10th March 2005 Last Modified: 10th March 2005 Status: Green (complete) Three Part Question In [infants with bronchiolitis] does [caffeine] [reduce or prevent apnoeas]? Clinical Scenario A 2-week-old infant, born at 36 weeks gestation was admitted to the paediatric ward in November with a 24h history of runny nose, cough and episodes of shallow breathing and apnoeas. This was thought
Interleukin 9 production in the lungs of infants with severe respiratory syncytial virus bronchiolitis. Respiratory syncytial virus (RSV) bronchiolitis is the most prevalent acute wheezing disorder in infants and is associated with recurrent wheeze and asthma in childhood. Interleukin 9, a type 2 cytokine has been proposed as a key cytokine in susceptibility to asthma. We aimed to investigate whether interleukin 9 was produced in the lungs of infants with severe RSV disease and if found, from (...) which cells it originated.We did 150 non-bronchoscopic bronchoalveolar lavages during the course of ventilation in 24 term infants and 21 preterm infants ventilated for RSV bronchiolitis. We also did 10 bronchoalveolar lavages on the day of intubation in 10 control infants ventilated for non-respiratory causes. We measured pulmonary interleukin 9 mRNA and protein in samples from all groups. We used immunostaining to identify the cells that produce interleukin 9.Interleukin 9 mRNA expression, which
Beta2-agonists for acute bronchitis. The optimal treatment for acute bronchitis is not clear. Because many patients with acute bronchitis have airflow limitation as well as cough, beta2-agonists may be useful.To determine whether beta2-agonists improve the symptoms of acute bronchitis in patients who do not have underlying pulmonary disease.The Cochrane Library (through August 2000), MEDLINE (1966 to 2000), EMBASE (1974 to 2000), and Conference Proceedings using "bronchodilator (exp (...) )", "adrenergic beta-agonist (exp)", or "sympathomimetics (exp)" and "bronchitis" or "cough"; Science Citation Index for referenced publications; and letters to manufacturers of beta2-agonists. An updated search of the Cochrane Central Register of Controlled Trials (CENTRAL) (issue 3, 2003); MEDLINE (January 2000 to July 2003); EMBASE (January 2000 to July 2003) was run in July 2003.Trials in which patients (adults or children over two years of age) without known pulmonary disease who were diagnosed
Glucocorticoids for acute viral bronchiolitis in infants and young children. Systemic glucocorticoids have been widely prescribed for use in infants and young children with acute viral bronchiolitis but the actual benefit of this intervention requires clarification.To systematically review the evidence on the effectiveness of systemic glucocorticoids for the treatment of infants and young children with acute viral bronchiolitis.Multiple strategies were incorporated to maximize identification (...) bronchiolitis and treated with systemic (oral, intramuscular or intravenous) corticosteroids. Three reviewers independently selected potentially relevant articles. Four reviewers evaluated these studies, determined eligibility and assessed the methodological quality of each RCT.The primary outcome of interest was length of hospital stay (LOS). Secondary outcomes were: respiratory rate, haemoglobin oxygen saturation, and hospital admission and revisit rates. Data were extracted independently by the four
Oral purified bacterial extracts in chronic bronchitis and COPD: systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Efficacy of interventions for bronchiolitis in critically ill infants: a systematic review and meta-analysis Efficacy of interventions for bronchiolitis in critically ill infants: a systematic review and meta-analysis Efficacy of interventions for bronchiolitis in critically ill infants: a systematic review and meta-analysis Davison C, Ventre K M, Luchetti M, Randolph A G CRD summary This review assessed treatments for critically ill infants with bronchiolitis. The authors concluded (...) that, currently, no treatment has been shown to be clearly effective, although surfactant appears promising and corticosteroids or ribavarin may be of benefit. There were some limitations to the review but, overall, the authors' cautious conclusions reflect the evidence. Authors' objectives To assess the efficacy of medical treatments for critically ill infants with bronchiolitis. Searching PubMed was searched from inception to October 2003 for studies reported in any language; the search terms were reported
A multicenter, randomized, double-blind, controlled trial of nebulized epinephrine in infants with acute bronchiolitis. The treatment of infants with bronchiolitis is largely supportive. The role of bronchodilators is controversial. Most studies of the use of bronchodilators have enrolled small numbers of subjects and have examined only short-term outcomes, such as clinical scores.We conducted a randomized, double-blind, controlled trial comparing nebulized single-isomer epinephrine (...) with placebo in 194 infants admitted to four hospitals in Queens-land, Australia, with a clinical diagnosis of bronchiolitis. Three 4-ml doses of 1 percent nebulized epinephrine or three 4-ml doses of normal saline were administered at four-hour intervals after hospital admission. Observations were made at admission and just before, 30 minutes after, and 60 minutes after each dose. The primary outcome measures were the length of the hospital stay and the time until the infant was ready for discharge
Management of bronchiolitis in infants and children Management of bronchiolitis in infants and children Management of bronchiolitis in infants and children Viswanathan M, King V, Bordley 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 Viswanathan M, King V, Bordley C. Management of bronchiolitis in infants and children. Rockville (...) : Agency for Healthcare Research and Quality (AHRQ). Evidence Report/Technology Assessment No. 69. 2003 Authors' objectives This systematic review seeks to clarify the existing knowledge base for the management of bronchiolitis and offers directions for future research. Specifically, the review addresses the effectiveness of appropriate diagnostic tools, the effectiveness of pharmaceutical therapies for treating bronchiolitis, the role of prophylactic therapy for prevention of bronchiolitis
Management of bronchiolitis in infants and children Management of bronchiolitis in infants and children Management of bronchiolitis in infants and children Vishwanathan M, King V J, Bordley C, Honeycutt A A, Wittenborn J, Jackman A M, Sutton S F, Lohr K N CRD summary This review assessed the management (diagnosis, treatment, prophylaxis) of bronchiolitis in infants and children. The authors concluded that there is insufficient evidence to recommend any of the treatment assessed over good (...) supportive care. The authors' conclusions are consistent with the evidence reviewed, and are likely to be robust. Authors' objectives To assess the effectiveness of diagnostic tools, pharmaceutical therapies and prophylactic therapies, and the cost-effectiveness of prophylactic treatment, in the management of bronchiolitis in infants and children. This abstract focused upon the diagnosis and treatment of existing bronchiolitis in infants and children. Searching MEDLINE, the Cochrane Library and HEED were