What Are Risk Factors for Progression To Severe Disease with Bronchiolitis?
Discussion
Bronchiolitis is a clinical disease with following features: begins usually with rhinitis and cough that may progress to also having tachypnea, rales, wheezing and increased work of breathing shown by nasal flaring and/or accessory muscle use. The increased work of breathing may cause problems with feeding and hydration and also with mental status changes. It is usually seen in infants and children < 2 years of age. It is also usually seasonal (winter in upper North America) with 60-70% of cases being caused by respiratory syncytial virus but also human rhinorvirus, human metapneumovirus, influenza, adenovirus, coronavirus and human and parainfluenza viruses. Co-infections also are relatively common.
Diagnosis is clinical. Treatment includes secretion removal from the nose, oxygen therapy if needed, maintenance of hydration and monitoring.
Specifically, new guidelines from the American Academy of Pediatrics for infants < 23 months of age, also in accordance with the National Health Service in the United Kingdom (with minor variations), state that the following should or should not occur:
Yes/Should
Diagnose bronchiolitis clinically
Assess risk factors for severe disease
Assess exposure to tobacco smoke and encourage smoking cessation in family members
May consider administration of
Hypertonic saline in hospitalized infants
Oxygen if saturations are < 90%
Should administer
Fluids by nasogastric tube or intravenously for hydration if needed
Palivizumab ...
Source: PediatricEducation.org - Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news
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