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By Roberto Garay-Cabada Pediatrics , Fellow in pediatric Pulmonology
Matti Korppi
AIM: In 2017, the European Respiratory Society task force stated that protracted bacterial bronchitis (PBB) was a distinct clinical entity and outlined the diagnostic criteria and principles for treatment. However, this guidance was based on data from Australia and the USA. This mini review evaluated the data and addressed the lack of research-based data from Europe. METHODS: We supplemented the 2017 report by conducting a nonsystematic review of the literature on prolonged wet or productive cough and on PBB in children up to September 2018...
December 23, 2018: Acta Paediatrica
Camilla Lavagno, Gregorio P Milani, Peter Uestuener, Giacomo D Simonetti, Carmen Casaulta, Mario G Bianchetti, Pietro B Fare, Sebastiano A G Lava
Hyponatremia (<135 mmol/L), typically associated with an elevated anti-diuretic hormone level, is common among children admitted with bronchiolitis, pneumonia, or pulmonary exacerbation of cystic fibrosis. The main consequences of acute hyponatremia include cerebral edema and Ayus-Arieff pulmonary edema. A widespread belief is that, in children with pneumonia or bronchiolitis, hyponatremia results from inappropriate anti-diuresis. By contrast, the pathogenic role of extracellular fluid volume depletion or decreased effective circulating blood volume is underscored...
July 2017: Pediatric Pulmonology
Audrey K S Soo, David P Inwald
Respiratory Syncytial Virus (RSV) is a common cause of bronchiolitis. Although there are a number of recognized complications, pulmonary hemorrhage has not been reported previously. A retrospective case notes review was performed through an electronic search of a Pediatric Intensive Care Unit's medical records. Seven patients with RSV infection and pulmonary hemorrhage were identified and included in this case series. Six of the seven patients were born prematurely (30-36 weeks gestation). All patients required blood transfusion...
June 2017: Pediatric Pulmonology
Todd A Florin, Amy C Plint, Joseph J Zorc
Viral bronchiolitis is a common clinical syndrome affecting infants and young children. Concern about its associated morbidity and cost has led to a large body of research that has been summarised in systematic reviews and integrated into clinical practice guidelines in several countries. The evidence and guideline recommendations consistently support a clinical diagnosis with the limited role for diagnostic testing for children presenting with the typical clinical syndrome of viral upper respiratory infection progressing to the lower respiratory tract...
January 14, 2017: Lancet
Michael B Anthracopoulos
No abstract text is available yet for this article.
September 2016: Acta Paediatrica
Susan Lu, Tina V Hartert, Mark L Everard, Hilde Giezek, Linda Nelsen, Anish Mehta, Hima Patel, Barbara Knorr, Theodore F Reiss
BACKGROUND: We sought to identify predictors of asthma development following severe early childhood RSV bronchiolitis. Different definitions of asthma were also compared. METHODS: This longitudinal, observational study (N = 343) followed patients (<2 years old) from a placebo-controlled trial (N = 979) of montelukast after RSV bronchiolitis to identify clinical, demographic, or biochemical predictors of asthma, atopic disorders, and chronic asthma therapy use at 6 years of age (Clinical Trials Registry Number: NCT01140048)...
December 2016: Pediatric Pulmonology
Jeffrey Baron, Gladys El-Chaar
Bronchiolitis, an infection of the lower respiratory tract, is the leading cause of infant and child hospitalization in the United States. Therapeutic options for management of bronchiolitis are limited. Hypertonic saline inhalation therapy has been studied in numerous clinical trials with mixed results. In 2014, the American Academy of Pediatrics (AAP) published updated guidelines on the diagnosis and management of bronchiolitis, which include new recommendations on the use of hypertonic saline. We reviewed all published clinical trials mentioned in the 2014 AAP guidelines, as well as additional trials published since the guidelines, and critically evaluated each trial to determine efficacy, safety, and expectations of hypertonic saline inhalation therapy...
January 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Marta Roqué i Figuls, Maria Giné-Garriga, Claudia Granados Rugeles, Carla Perrotta, Jordi Vilaró
BACKGROUND: This Cochrane review was first published in 2005 and updated in 2007, 2012 and now 2015. Acute bronchiolitis is the leading cause of medical emergencies during winter in children younger than two years of age. Chest physiotherapy is sometimes used to assist infants in the clearance of secretions in order to decrease ventilatory effort. OBJECTIVES: To determine the efficacy of chest physiotherapy in infants aged less than 24 months old with acute bronchiolitis...
February 1, 2016: Cochrane Database of Systematic Reviews
M Luz Garcia-Garcia, Cristina Calvo Rey, Teresa Del Rosal Rabes
Respiratory viral infections, particularly respiratory syncytial virus (RSV) and rhinovirus, are the most importance risk factors for the onset of wheezing in infants and small children. Bronchiolitis is the most common acute respiratory infection in children under 1year of age, and the most common cause of hospitalization in this age group. RSV accounts for approximately 70% of all these cases, followed by rhinovirus, adenovirus, metapneumovirus and bocavirus. The association between bronchiolitis caused by RSV and the development of recurrent wheezing and/or asthma was first described more than 40years ago, but it is still unclear whether bronchiolitis causes chronic respiratory symptoms, or if it is a marker for children with a genetic predisposition for developing asthma in the medium or long term...
May 2016: Archivos de Bronconeumología
Diana S Balekian, Rachel W Linnemann, Victor M Castro, Roy Perlis, Ravi Thadhani, Carlos A Camargo
BACKGROUND: Infants hospitalized for bronchiolitis (i.e. severe bronchiolitis) are at increased risk of childhood asthma. There are many known risk factors for severe bronchiolitis, including cardiac and pulmonary diseases. Less is known about the association between atopic diseases and risk of severe bronchiolitis. We sought to further examine risk factors for severe bronchiolitis, focusing on atopic dermatitis (AD). METHODS: We conducted a nested cohort study within the Massachusetts General Hospital Obstetric Maternal Study (MOMS), a prospective cohort of pregnant women enrolled during 1998-2006...
June 2016: Pediatric Allergy and Immunology
H Cody Meissner
No abstract text is available yet for this article.
January 7, 2016: New England Journal of Medicine
Manuel Sanchez-Luna, Francisco J Elola, Cristina Fernandez-Perez, Jose L Bernal, Adriana Lopez-Pineda
OBJECTIVE: To analyze trends in health outcomes and the influence of risk factors in children under 1 year with acute bronchiolitis due to respiratory syncytial virus (RSV bronchiolitis). A risk-adjustment model for RSV bronchiolitis in-hospital mortality was also developed. RESEARCH DESIGN AND METHODS: Retrospective study of hospitalizations for RSV bronchiolitis in children aged <1 year from 2004 to 2012. We used nationally representative data from the Spanish National Health Service records...
2016: Current Medical Research and Opinion
Kohei Hasegawa, Rachel W Linnemann, Vasanthi Avadhanula, Jonathan M Mansbach, Pedro A Piedra, James E Gern, Carlos A Camargo
BACKGROUND: Despite the research importance of rhinovirus detection in asymptomatic healthy infants, the literature remains sparse. OBJECTIVE: To investigate the prevalence of respiratory syncytial virus (RSV) and rhinovirus (and its species). METHODS: We conducted a cross-sectional study of 110 healthy, non-hospitalized infants without acute illness at an academic medical center from November 2013 through May 2014. We tested nasal swab specimens by using polymerase chain reaction and genetic sequencing...
November 25, 2015: BMC Research Notes
Amber M Richards
Respiratory emergencies are 1 of the most common reasons parents seek evaluation for the their children in the emergency department (ED) each year, and respiratory failure is the most common cause of cardiopulmonary arrest in pediatric patients. Whereas many respiratory illnesses are mild and self-limiting, others are life threatening and require prompt diagnosis and management. Therefore, it is imperative that emergency clinicians be able to promptly recognize and manage these illnesses. This article reviews ED diagnosis and management of foreign body aspiration, asthma exacerbation, epiglottitis, bronchiolitis, community-acquired pneumonia, and pertussis...
February 2016: Emergency Medicine Clinics of North America
Silvana Schreiber, Luca Ronfani, Sergio Ghirardo, Federico Minen, Andrea Taddio, Mohamad Jaber, Elisa Rizzello, Egidio Barbi
AIM: Published guidelines do not recommend nasal irrigation in bronchiolitis, but it is common practice in Italy, despite a lack of data on its benefits or adverse effects. This single-blind, multicentre, randomised controlled trial compared nasal irrigation using either isotonic 0.9% sodium chloride or hypertonic 3% sodium chloride with simple supportive care in infants with bronchiolitis. METHODS: We randomly assigned 133 infants up one year of age, who were admitted to the emergency department with bronchiolitis and an oxygen saturation (SpO2) of between 88 and 94%, to the isotonic (n = 47), hypertonic (n = 44) or standard care (n = 42) groups...
March 2016: Acta Paediatrica
Chin Maguire, Hannah Cantrill, Daniel Hind, Mike Bradburn, Mark L Everard
BACKGROUND: Acute bronchiolitis is the commonest cause of hospitalisation in infancy. Currently management consists of supportive care and oxygen. A Cochrane review concluded that, "nebulised 3 % saline may significantly reduce the length of hospital stay". We conducted a systematic review of controlled trials of nebulised hypertonic saline (HS) for infants hospitalised with primary acute bronchiolitis. METHODS: Searches to January 2015 involved: Cochrane Central Register of Controlled Trials; Ovid MEDLINE; Embase; Google Scholar; Web of Science; and, a variety of trials registers...
November 23, 2015: BMC Pulmonary Medicine
J Carlos Flores-González, Miguel A Matamala-Morillo, Patricia Rodríguez-Campoy, Juan J Pérez-Guerrero, Belén Serrano-Moyano, Paloma Comino-Vazquez, Encarnación Palma-Zambrano, Rocio Bulo-Concellón, Vanessa Santos-Sánchez, Alfonso M Lechuga-Sancho
BACKGROUND AND AIMS: There is no evidence that the epinephrine-3% hypertonic saline combination is more effective than 3% hypertonic saline alone for treating infants hospitalized with acute bronchiolitis. We evaluated the efficacy of nebulized epinephrine in 3% hypertonic saline. PATIENTS AND METHODS: We performed a randomized, double-blind, placebo-controlled clinical trial in 208 infants hospitalized with acute moderate bronchiolitis. Infants were randomly assigned to receive nebulized 3% hypertonic saline with either 3 mL of epinephrine or 3 mL of placebo, administered every four hours...
2015: PloS One
Alyssa H Silver, Nora Esteban-Cruciani, Gabriella Azzarone, Lindsey C Douglas, Diana S Lee, Sheila Liewehr, Joanne M Nazif, Ilir Agalliu, Susan Villegas, Hai Jung H Rhim, Michael L Rinke, Katherine O'Connor
BACKGROUND AND OBJECTIVES: Bronchiolitis, the most common reason for hospitalization in children younger than 1 year in the United States, has no proven therapies effective beyond supportive care. We aimed to investigate the effect of nebulized 3% hypertonic saline (HS) compared with nebulized normal saline (NS) on length of stay (LOS) in infants hospitalized with bronchiolitis. METHODS: We conducted a prospective, randomized, double-blind, controlled trial in an urban tertiary care children's hospital in 227 infants younger than 12 months old admitted with a diagnosis of bronchiolitis (190 completed the study); 113 infants were randomized to HS (93 completed the study), and 114 to NS (97 completed the study)...
December 2015: Pediatrics
Linjie Zhang, Raúl A Mendoza-Sassi, Terry P Klassen, Claire Wainwright
BACKGROUND AND OBJECTIVE: The mainstay of treatment for acute bronchiolitis remains supportive care. The objective of this study was to assess the efficacy and safety of nebulized hypertonic saline (HS) in infants with acute bronchiolitis. METHODS: Data sources included PubMed and the Virtual Health Library of the Latin American and Caribbean Center on Health Sciences Information up to May 2015. Studies selected were randomized or quasi-randomized controlled trials comparing nebulized HS with 0...
October 2015: Pediatrics
James A Lin, Andranik Madikians
Acute viral bronchiolitis is a leading cause of admission to pediatric intensive care units, but research on the care of these critically ill infants has been limited. Pathology of viral bronchiolitis revealed respiratory obstruction due to intraluminal debris and edema of the airways and vasculature. This and clinical evidence suggest that airway clearance interventions such as hypertonic saline nebulizers and pulmonary toilet devices may be of benefit, particularly in situations of atelectasis associated with bronchiolitis...
August 4, 2015: World Journal of Critical Care Medicine
2015-09-01 05:43:10
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