Inter-society consensus document on treatment and prevention of bronchiolitis in newborns and infants
Acute bronchiolitis is the leading cause of lower respiratory tract infection and hospitalization in children less than 1 year of age worldwide. It is usually a mild disease, but some children may develop severe symptoms, requiring hospital admission and ventilatory support in the ICU. Infants with...
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| Veröffentlicht in: | Italian journal of pediatrics 2014-10, Vol.40 (1), p.65-65, Article 65 |
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| creator | Baraldi, Eugenio Lanari, Marcello Manzoni, Paolo Rossi, Giovanni A Vandini, Silvia Rimini, Alessandro Romagnoli, Costantino Colonna, Pierluigi Biondi, Andrea Biban, Paolo Chiamenti, Giampietro Bernardini, Roberto Picca, Marina Cappa, Marco Magazzù, Giuseppe Catassi, Carlo Urbino, Antonio Francesco Memo, Luigi Donzelli, Gianpaolo Minetti, Carlo Paravati, Francesco Di Mauro, Giuseppe Festini, Filippo Esposito, Susanna Corsello, Giovanni |
| description | Acute bronchiolitis is the leading cause of lower respiratory tract infection and hospitalization in children less than 1 year of age worldwide. It is usually a mild disease, but some children may develop severe symptoms, requiring hospital admission and ventilatory support in the ICU. Infants with pre-existing risk factors (prematurity, bronchopulmonary dysplasia, congenital heart diseases and immunodeficiency) may be predisposed to a severe form of the disease. Clinical diagnosis of bronchiolitis is manly based on medical history and physical examination (rhinorrhea, cough, crackles, wheezing and signs of respiratory distress). Etiological diagnosis, with antigen or genome detection to identify viruses involved, may have a role in reducing hospital transmission of the infection. Criteria for hospitalization include low oxygen saturation ( |
| doi_str_mv | 10.1186/1824-7288-40-65 |
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It is usually a mild disease, but some children may develop severe symptoms, requiring hospital admission and ventilatory support in the ICU. Infants with pre-existing risk factors (prematurity, bronchopulmonary dysplasia, congenital heart diseases and immunodeficiency) may be predisposed to a severe form of the disease. Clinical diagnosis of bronchiolitis is manly based on medical history and physical examination (rhinorrhea, cough, crackles, wheezing and signs of respiratory distress). Etiological diagnosis, with antigen or genome detection to identify viruses involved, may have a role in reducing hospital transmission of the infection. Criteria for hospitalization include low oxygen saturation (<90-92%), moderate-to-severe respiratory distress, dehydration and presence of apnea. Children with pre-existing risk factors should be carefully assessed.To date, there is no specific treatment for viral bronchiolitis, and the mainstay of therapy is supportive care. This consists of nasal suctioning and nebulized 3% hypertonic saline, assisted feeding and hydration, humidified O2 delivery. The possible role of any pharmacological approach is still debated, and till now there is no evidence to support the use of bronchodilators, corticosteroids, chest physiotherapy, antibiotics or antivirals. Nebulized adrenaline may be sometimes useful in the emergency room. Nebulized adrenaline can be useful in the hospital setting for treatment as needed. Lacking a specific etiological treatment, prophylaxis and prevention, especially in children at high risk of severe infection, have a fundamental role. Environmental preventive measures minimize viral transmission in hospital, in the outpatient setting and at home. Pharmacological prophylaxis with palivizumab for RSV bronchiolitis is indicated in specific categories of children at risk during the epidemic period. Viral bronchiolitis, especially in the case of severe form, may correlate with an increased incidence of recurrent wheezing in pre-schooled children and with asthma at school age.The aim of this document is to provide a multidisciplinary update on the current recommendations for the management and prevention of bronchiolitis, in order to share useful indications, identify gaps in knowledge and drive future research.</description><identifier>ISSN: 1824-7288</identifier><identifier>ISSN: 1720-8424</identifier><identifier>EISSN: 1824-7288</identifier><identifier>DOI: 10.1186/1824-7288-40-65</identifier><identifier>PMID: 25344148</identifier><language>eng</language><publisher>England: BioMed Central</publisher><subject>Adrenergic beta-2 Receptor Antagonists - therapeutic use ; Anti-Bacterial Agents - therapeutic use ; Antibodies, Monoclonal, Humanized - therapeutic use ; Antiviral Agents - therapeutic use ; Bronchiolitis - diagnosis ; Bronchiolitis - therapy ; Bronchodilator Agents - therapeutic use ; Children & youth ; Decision Making ; Drug therapy ; Environmental Exposure - prevention & control ; Epinephrine - therapeutic use ; Glucocorticoids - therapeutic use ; Hospitalization ; Hospitals ; Humans ; Humidity ; Infant, Newborn ; Intensive Care Units, Neonatal ; Mortality ; Nebulizers and Vaporizers ; Oxygen Inhalation Therapy ; Palivizumab ; Patient Discharge ; Primary Health Care ; Respiratory Therapy ; Review ; Saline Solution, Hypertonic - administration & dosage ; Severity of Illness Index ; Vitamin D - therapeutic use ; Vitamins - therapeutic use</subject><ispartof>Italian journal of pediatrics, 2014-10, Vol.40 (1), p.65-65, Article 65</ispartof><rights>2014 Baraldi et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</rights><rights>Baraldi et al.; licensee BioMed Central Ltd. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b547t-97752ad51e2348bc6f43f149d30b2f766de8a255c912a17e4b7f576313cb1aac3</citedby><cites>FETCH-LOGICAL-b547t-97752ad51e2348bc6f43f149d30b2f766de8a255c912a17e4b7f576313cb1aac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364570/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364570/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25344148$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baraldi, Eugenio</creatorcontrib><creatorcontrib>Lanari, Marcello</creatorcontrib><creatorcontrib>Manzoni, Paolo</creatorcontrib><creatorcontrib>Rossi, Giovanni A</creatorcontrib><creatorcontrib>Vandini, Silvia</creatorcontrib><creatorcontrib>Rimini, Alessandro</creatorcontrib><creatorcontrib>Romagnoli, Costantino</creatorcontrib><creatorcontrib>Colonna, Pierluigi</creatorcontrib><creatorcontrib>Biondi, Andrea</creatorcontrib><creatorcontrib>Biban, Paolo</creatorcontrib><creatorcontrib>Chiamenti, Giampietro</creatorcontrib><creatorcontrib>Bernardini, Roberto</creatorcontrib><creatorcontrib>Picca, Marina</creatorcontrib><creatorcontrib>Cappa, Marco</creatorcontrib><creatorcontrib>Magazzù, Giuseppe</creatorcontrib><creatorcontrib>Catassi, Carlo</creatorcontrib><creatorcontrib>Urbino, Antonio Francesco</creatorcontrib><creatorcontrib>Memo, Luigi</creatorcontrib><creatorcontrib>Donzelli, Gianpaolo</creatorcontrib><creatorcontrib>Minetti, Carlo</creatorcontrib><creatorcontrib>Paravati, Francesco</creatorcontrib><creatorcontrib>Di Mauro, Giuseppe</creatorcontrib><creatorcontrib>Festini, Filippo</creatorcontrib><creatorcontrib>Esposito, Susanna</creatorcontrib><creatorcontrib>Corsello, Giovanni</creatorcontrib><title>Inter-society consensus document on treatment and prevention of bronchiolitis in newborns and infants</title><title>Italian journal of pediatrics</title><addtitle>Ital J Pediatr</addtitle><description>Acute bronchiolitis is the leading cause of lower respiratory tract infection and hospitalization in children less than 1 year of age worldwide. It is usually a mild disease, but some children may develop severe symptoms, requiring hospital admission and ventilatory support in the ICU. Infants with pre-existing risk factors (prematurity, bronchopulmonary dysplasia, congenital heart diseases and immunodeficiency) may be predisposed to a severe form of the disease. Clinical diagnosis of bronchiolitis is manly based on medical history and physical examination (rhinorrhea, cough, crackles, wheezing and signs of respiratory distress). Etiological diagnosis, with antigen or genome detection to identify viruses involved, may have a role in reducing hospital transmission of the infection. Criteria for hospitalization include low oxygen saturation (<90-92%), moderate-to-severe respiratory distress, dehydration and presence of apnea. Children with pre-existing risk factors should be carefully assessed.To date, there is no specific treatment for viral bronchiolitis, and the mainstay of therapy is supportive care. This consists of nasal suctioning and nebulized 3% hypertonic saline, assisted feeding and hydration, humidified O2 delivery. The possible role of any pharmacological approach is still debated, and till now there is no evidence to support the use of bronchodilators, corticosteroids, chest physiotherapy, antibiotics or antivirals. Nebulized adrenaline may be sometimes useful in the emergency room. Nebulized adrenaline can be useful in the hospital setting for treatment as needed. Lacking a specific etiological treatment, prophylaxis and prevention, especially in children at high risk of severe infection, have a fundamental role. Environmental preventive measures minimize viral transmission in hospital, in the outpatient setting and at home. Pharmacological prophylaxis with palivizumab for RSV bronchiolitis is indicated in specific categories of children at risk during the epidemic period. Viral bronchiolitis, especially in the case of severe form, may correlate with an increased incidence of recurrent wheezing in pre-schooled children and with asthma at school age.The aim of this document is to provide a multidisciplinary update on the current recommendations for the management and prevention of bronchiolitis, in order to share useful indications, identify gaps in knowledge and drive future research.</description><subject>Adrenergic beta-2 Receptor Antagonists - therapeutic use</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibodies, Monoclonal, Humanized - therapeutic use</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Bronchiolitis - diagnosis</subject><subject>Bronchiolitis - therapy</subject><subject>Bronchodilator Agents - therapeutic use</subject><subject>Children & youth</subject><subject>Decision Making</subject><subject>Drug therapy</subject><subject>Environmental Exposure - prevention & control</subject><subject>Epinephrine - 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It is usually a mild disease, but some children may develop severe symptoms, requiring hospital admission and ventilatory support in the ICU. Infants with pre-existing risk factors (prematurity, bronchopulmonary dysplasia, congenital heart diseases and immunodeficiency) may be predisposed to a severe form of the disease. Clinical diagnosis of bronchiolitis is manly based on medical history and physical examination (rhinorrhea, cough, crackles, wheezing and signs of respiratory distress). Etiological diagnosis, with antigen or genome detection to identify viruses involved, may have a role in reducing hospital transmission of the infection. Criteria for hospitalization include low oxygen saturation (<90-92%), moderate-to-severe respiratory distress, dehydration and presence of apnea. Children with pre-existing risk factors should be carefully assessed.To date, there is no specific treatment for viral bronchiolitis, and the mainstay of therapy is supportive care. This consists of nasal suctioning and nebulized 3% hypertonic saline, assisted feeding and hydration, humidified O2 delivery. The possible role of any pharmacological approach is still debated, and till now there is no evidence to support the use of bronchodilators, corticosteroids, chest physiotherapy, antibiotics or antivirals. Nebulized adrenaline may be sometimes useful in the emergency room. Nebulized adrenaline can be useful in the hospital setting for treatment as needed. Lacking a specific etiological treatment, prophylaxis and prevention, especially in children at high risk of severe infection, have a fundamental role. Environmental preventive measures minimize viral transmission in hospital, in the outpatient setting and at home. Pharmacological prophylaxis with palivizumab for RSV bronchiolitis is indicated in specific categories of children at risk during the epidemic period. Viral bronchiolitis, especially in the case of severe form, may correlate with an increased incidence of recurrent wheezing in pre-schooled children and with asthma at school age.The aim of this document is to provide a multidisciplinary update on the current recommendations for the management and prevention of bronchiolitis, in order to share useful indications, identify gaps in knowledge and drive future research.</abstract><cop>England</cop><pub>BioMed Central</pub><pmid>25344148</pmid><doi>10.1186/1824-7288-40-65</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1824-7288 |
| ispartof | Italian journal of pediatrics, 2014-10, Vol.40 (1), p.65-65, Article 65 |
| issn | 1824-7288 1720-8424 1824-7288 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4364570 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; Springer Nature OA Free Journals; Springer Nature - Complete Springer Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adrenergic beta-2 Receptor Antagonists - therapeutic use Anti-Bacterial Agents - therapeutic use Antibodies, Monoclonal, Humanized - therapeutic use Antiviral Agents - therapeutic use Bronchiolitis - diagnosis Bronchiolitis - therapy Bronchodilator Agents - therapeutic use Children & youth Decision Making Drug therapy Environmental Exposure - prevention & control Epinephrine - therapeutic use Glucocorticoids - therapeutic use Hospitalization Hospitals Humans Humidity Infant, Newborn Intensive Care Units, Neonatal Mortality Nebulizers and Vaporizers Oxygen Inhalation Therapy Palivizumab Patient Discharge Primary Health Care Respiratory Therapy Review Saline Solution, Hypertonic - administration & dosage Severity of Illness Index Vitamin D - therapeutic use Vitamins - therapeutic use |
| title | Inter-society consensus document on treatment and prevention of bronchiolitis in newborns and infants |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-21T07%3A30%3A58IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Inter-society%20consensus%20document%20on%20treatment%20and%20prevention%20of%20bronchiolitis%20in%20newborns%20and%20infants&rft.jtitle=Italian%20journal%20of%20pediatrics&rft.au=Baraldi,%20Eugenio&rft.date=2014-10-24&rft.volume=40&rft.issue=1&rft.spage=65&rft.epage=65&rft.pages=65-65&rft.artnum=65&rft.issn=1824-7288&rft.eissn=1824-7288&rft_id=info:doi/10.1186/1824-7288-40-65&rft_dat=%3Cproquest_pubme%3E3471039481%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1616260120&rft_id=info:pmid/25344148&rfr_iscdi=true |