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Review
. 2009 Jun;19(6):266-270.
doi: 10.1016/j.paed.2009.03.001. Epub 2009 May 13.

Management of bronchiolitis

Madeleine Adams  1   2 , Iolo Doull  1   2
Affiliations
Review

Management of bronchiolitis

Madeleine Adams et al. Paediatr Child Health (Oxford). 2009 Jun.

Abstract

Bronchiolitis is the commonest cause of hospital admission in infancy. Severity varies from mild and self-limiting through to respiratory failure requiring intensive care and ventilation. Many viruses cause bronchiolitis, the commonest being respiratory syncytial virus (RSV). Supportive care is the mainstay of treatment, with emphasis on fluid replacement and oxygen therapy. Agents with evidence of no benefit in acute bronchiolitis include β2 agonists, ipratropium, montelukast, corticosteroids, antiviral agents such as ribavirin or RSV immunoglobulin, physiotherapy, nebulized deoxyribonuclease or antibiotics. It is possible that nebulized epinephrine has a small short-term effect, and that nebulized 3% hypertonic saline administered with a bronchodilator may decrease length of stay in hospital. Preventative strategies such as RSV immunoglobulin or the anti-RSV monoclonal antibody palivizumab can decrease disease severity.

Keywords: RSV; bronchiolitis; bronchodilators; corticosteroids; hypertonic saline.

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