| HOME | HELP | E-MAIL ALERTS | SEARCH |
|
PEDIATRICS Vol. 118 No. 4 October 2006, pp. 1774-1793 (doi:10.1542/peds.2006-2223)
| ||||||||||||||||||||||||||||||||||||||||||||||||
CLINICAL PRACTICE GUIDELINE |
Bronchiolitis is a disorder most commonly caused in infants by viral lower respiratory tract infection. It is the most common lower respiratory infection in this age group. It is characterized by acute inflammation, edema, and necrosis of epithelial cells lining small airways, increased mucus production, and bronchospasm.
The American Academy of Pediatrics convened a committee composed of primary care physicians and specialists in the fields of pulmonology, infectious disease, emergency medicine, epidemiology, and medical informatics. The committee partnered with the Agency for Healthcare Research and Quality and the RTI International-University of North Carolina Evidence-Based Practice Center to develop a comprehensive review of the evidence-based literature related to the diagnosis, management, and prevention of bronchiolitis. The resulting evidence report and other sources of data were used to formulate clinical practice guideline recommendations.
This guideline addresses the diagnosis of bronchiolitis as well as various therapeutic interventions including bronchodilators, corticosteroids, antiviral and antibacterial agents, hydration, chest physiotherapy, and oxygen. Recommendations are made for prevention of respiratory syncytial virus infection with palivizumab and the control of nosocomial spread of infection. Decisions were made on the basis of a systematic grading of the quality of evidence and strength of recommendation. The clinical practice guideline underwent comprehensive peer review before it was approved by the American Academy of Pediatrics.
This clinical practice guideline is not intended as a sole source of guidance in the management of children with bronchiolitis. Rather, it is intended to assist clinicians in decision-making. It is not intended to replace clinical judgment or establish a protocol for the care of all children with this condition. These recommendations may not provide the only appropriate approach to the management of children with bronchiolitis.
Key Words: bronchiolitis
Abbreviations: CAM—complementary and alternative medicine • LRTI—lower respiratory tract infection • AHRQ—Agency for Healthcare Research and Quality • RSV—respiratory syncytial virus • AAP—American Academy of Pediatrics • AAFP—American Academy of Family Physicians • RCT—randomized, controlled trial • CLD—chronic neonatal lung disease • SBI—serious bacterial infection • UTI—urinary tract infection • AOM—acute otitis media • SpO2—oxyhemoglobin saturation • LRTD—lower respiratory tract disease
This article has been cited by other articles:
 |
|
 |
|
  W. G. Nichols, A. J. Peck Campbell, and M. Boeckh Respiratory Viruses Other than Influenza Virus: Impact and Therapeutic Advances Clin. Microbiol. Rev., April 1, 2008; 21(2): 274 - 290. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Schildgen, A. Muller, T. Allander, I. M. Mackay, S. Volz, B. Kupfer, and A. Simon Human Bocavirus: Passenger or Pathogen in Acute Respiratory Tract Infections? Clin. Microbiol. Rev., April 1, 2008; 21(2): 291 - 304. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Mansbach, S. Clark, N. C. Christopher, F. LoVecchio, S. Kunz, U. Acholonu, and C. A. Camargo Jr Prospective Multicenter Study of Bronchiolitis: Predicting Safe Discharges From the Emergency Department Pediatrics, April 1, 2008; 121(4): 680 - 688. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Unger and S. Cunningham Effect of Oxygen Supplementation on Length of Stay for Infants Hospitalized With Acute Viral Bronchiolitis Pediatrics, March 1, 2008; 121(3): 470 - 475. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. L. Yorita, R. C. Holman, J. J. Sejvar, C. A. Steiner, and L. B. Schonberger Infectious Disease Hospitalizations Among Infants in the United States Pediatrics, February 1, 2008; 121(2): 244 - 252. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-A. S. Harris, W. C. Huskins, J. M. Langley, J. D. Siegel, and for the Pediatric Special Interest Group of the So Health Care Epidemiology Perspective on the October 2006 Recommendations of the Subcommittee on Diagnosis and Management of Bronchiolitis Pediatrics, October 1, 2007; 120(4): 890 - 892. [Full Text] [PDF]
|
|
|
|
|
|
C. B. Hall and A. S. Lieberthal Viral Testing and Isolation of Patients With Bronchiolitis Pediatrics, October 1, 2007; 120(4): 893 - 894. [Full Text] [PDF]
|
|
|
|
|
|
J. L. Bass and D. Gozal Oxygen Therapy for Bronchiolitis: In Reply Pediatrics, September 1, 2007; 120(3): 687 - 688. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Weinberger Corticosteroids Revisited for Acute Bronchiolitis in Hospitalized Children AAP Grand Rounds, August 1, 2007; 18(2): 13 - 13. [Full Text] [PDF]
|
|
|
|
|
|
R. I. Paul and M. Weinberger Routine Chest Radiographs in Acute Bronchiolitis Are Not Necessary AAP Grand Rounds, August 1, 2007; 18(2): 14 - 15. [Full Text] [PDF]
|
|
|
|
|
|
R. N. Shiffman and A. S. Lieberthal The Importance of Disclaimers: Distinction Between Optimal Care and Standard of Care: In Reply Pediatrics, August 1, 2007; 120(2): 455 - 455. [Full Text] [PDF]
|
|
|
|
|
|
E. J. Slosberg and C. G. Smith Jr, Esquir The Importance of Disclaimers: Distinction Between Optimal Care and Standard of Care Pediatrics, August 1, 2007; 120(2): 453 - 455. [Full Text] [PDF]
|
|
|
|
 |
|
 H. M. Corneli, J. J. Zorc, P. Mahajan, K. N. Shaw, R. Holubkov, S. D. Reeves, R. M. Ruddy, B. Malik, K. A. Nelson, J. S. Bregstein, et al. A Multicenter, Randomized, Controlled Trial of Dexamethasone for Bronchiolitis N. Engl. J. Med., July 26, 2007; 357(4): 331 - 339. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. B. Hall Therapy for Bronchiolitis: When Some Become None N. Engl. J. Med., July 26, 2007; 357(4): 402 - 404. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Korppi Macrolides and bronchiolitis in infants Eur. Respir. J., June 1, 2007; 29(6): 1283 - 1284. [Full Text] [PDF]
|
|
|
|
|
|
F. Tahan From the authors Eur. Respir. J., June 1, 2007; 29(6): 1284 - 1285. [Full Text] [PDF]
|
|
|
|
|
|
E. A.F. Simoes Maternal Smoking, Asthma, and Bronchiolitis: Clear-Cut Association or Equivocal Evidence? Pediatrics, June 1, 2007; 119(6): 1210 - 1212. [Full Text] [PDF]
|
|
|
|
|
|
A. S. Lieberthal High-Dose Systemic Corticosteroids May Be Effective Early in the Course of Bronchiolitis: In Reply Pediatrics, April 1, 2007; 119(4): 865 - 866. [Full Text] [PDF]
|
|
|
|
|
|
M. M. Weinberger High-Dose Systemic Corticosteroids May Be Effective Early in the Course of Bronchiolitis Pediatrics, April 1, 2007; 119(4): 864 - 865. [Full Text] [PDF]
|
|
|
|
|
|
J. L. Bass and D. Gozal Oxygen Therapy for Bronchiolitis Pediatrics, March 1, 2007; 119(3): 611 - 611. [Full Text] [PDF]
|
|
|
|
 |
|
 New Bronchiolitis Guidelines Journal Watch Pediatrics and Adolescent Medicine, January 10, 2007; 2007(110): 3 - 3. [Full Text]
|
|
|
|
 |
|
 S. Cash AAP offers evidence-based recommendations for diagnosing, treating bronchiolitis in infants AAP News, October 1, 2006; 27(10): 1 - 12. [Full Text]
|
|
| HOME | HELP | E-MAIL ALERTS | SEARCH |
