Bronchiolitis

Summary Viral bronchiolitis is the most common cause of admission to hospital for infants in high-income countries. Respiratory syncytial virus accounts for 60–80% of bronchiolitis presentations. Bronchiolitis is diagnosed clinically without the need for viral testing. Management recommendations, ba...

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Bibliographic Details
Published in:The Lancet (British edition) 2022-07, Vol.400 (10349), p.392-406
Main Authors: Dalziel, Stuart R, Haskell, Libby, O'Brien, Sharon, Borland, Meredith L, Plint, Amy C, Babl, Franz E, Oakley, Ed
Format: Article
Language:English
Subjects:
Age
Asthma
Auscultation
Bacterial infections
Bronchodilators
Bronchopneumonia
Chlamydia
Clinical practice guidelines
Congenital diseases
Electrolytes
Glucocorticoids
Humidity
Hypoxia
Illnesses
Infants
Infections
Intubation
Oxygenation
Pathophysiology
Public health
Respiratory syncytial virus
Risk factors
Severe acute respiratory syndrome coronavirus 2
Therapy
Viral infections
Viruses
Whooping cough
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Summary:Summary Viral bronchiolitis is the most common cause of admission to hospital for infants in high-income countries. Respiratory syncytial virus accounts for 60–80% of bronchiolitis presentations. Bronchiolitis is diagnosed clinically without the need for viral testing. Management recommendations, based predominantly on high-quality evidence, advise clinicians to support hydration and oxygenation only. Evidence suggests no benefit with use of glucocorticoids or bronchodilators, with further evidence required to support use of hypertonic saline in bronchiolitis. Evidence is scarce in the intensive care unit. Evidence suggests use of high-flow therapy in bronchiolitis is limited to rescue therapy after failure of standard subnasal oxygen only in infants who are hypoxic and does not decrease rates of intensive care unit admission or intubation. Despite systematic reviews and international clinical practice guidelines promoting supportive rather than interventional therapy, universal de-implementation of interventional care in bronchiolitis has not occurred and remains a major challenge.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(22)01016-9