Bronchiolitis Care in the Hospital

Author(s): Jennifer Orr Vincent*, Huay-ying Lo, Susan Wu.

Journal Name: Reviews on Recent Clinical Trials

Volume 12 , Issue 4 , 2017

Abstract:

Background: Viral bronchiolitis is a common cause of hospitalization in young children, but despite a variety of therapeutic options, the mainstay of treatment remains supportive care.

Objective: To examine the most recent evidence for supportive care measures and pharmacologic options in the treatment of bronchiolitis in the hospital setting.

Method: MEDLINE search with expert medical librarian for publications on management and therapies for bronchiolitis.

Results: Evidence does not support the use of bronchodilators, racemic epinephrine, deep suctioning, systemic corticosteroids, or antibiotics in the absence of a concomitant bacterial infection, as these treatments do not change the course of illness or shorten length of stay (LOS). Nebulized hypertonic saline is not routinely recommended, though it may provide some benefit for patients with anticipated prolonged LOS. Continuous pulse oximetry should not be routinely used in stable patients as it may be associated with longer LOS. Supplemental oxygen should be used to maintain oxyhemoglobin concentrations ≥90%, a level lower than what many clinicians may have used previously. Current evidence suggests high-flow nasal cannula may reduce intubation rate, but its effect on LOS is unclear. Intravenous or nasogastric tube hydration should be used when oral hydration is not sufficient.

Conclusion: Overall, bronchiolitis remains a self-limited disease whose mainstay of therapy is supportive care.

Keywords: Bronchiolitis, high-flow nasal cannula (HFNC), hypertonic saline (HTS), length-of-stay (LOS), oxygen, respiratory syncytial virus (RSV).

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Article Details

VOLUME: 12
ISSUE: 4
Year: 2017
Page: [246 - 252]
Pages: 7
DOI: 10.2174/1574887112666170816152832
Price: $58

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