[Bronchiolitis. We know what is the reason and how to treat]

Abstract

Bronchilitis is one of the most common respiratory diseases in infants and early childhood (< 2 ys of age). The diagnosis is clinical and laboratory tests support only recognition of the severity level of the disease. In most cases, the main reason of inflammation are viruses: RSV, rhinovirus. In the terminal bronchioles, inflammation process includes: edema, necrosis of epithelial cells, production of mucus, and possibly some degree of bronchospasm. For decades, controversy has surrounded the treatment of bronchiolitis. Last published consensuses and reviews indicate that use of bronchodilators, antibiotics, steroids systemic or inhaled, montelukast, ribavirin does not improve the symptoms of disease and is not routinely recommended. Recent studies suggest that nebulized hypertonic saline may substantially modify the course of disease. Moreover, there are no significant or frequent adverse effects noted in this treatment. It is believed that increased hydration of the airway mucus with inhalation of NaCl solutions will be routinely accepted treatment of children with bronchiolitis.