Bronchiolitis: Difference between revisions
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==Treatment== | ==Treatment== | ||
[[Bronchiolitis medical therapy|Medical therapy]] | [[Bronchiolitis surgery|Surgical options]] | [[Bronchiolitis primary prevention|Primary prevention]] | [[Bronchiolitis secondary prevention|Secondary prevention]] | [[Bronchiolitis cost-effectiveness of therapy|Financial costs]] | [[Bronchiolitis future or investigational therapies|Future therapies]] | [[Bronchiolitis medical therapy|Medical therapy]] | [[Bronchiolitis surgery|Surgical options]] | [[Bronchiolitis primary prevention|Primary prevention]] | [[Bronchiolitis secondary prevention|Secondary prevention]] | [[Bronchiolitis cost-effectiveness of therapy|Financial costs]] | [[Bronchiolitis future or investigational therapies|Future therapies]] | ||
==Treatment== | ==Treatment== | ||
Revision as of 20:30, 23 January 2012
| Bronchiolitis | |
| ICD-10 | J21 |
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| ICD-9 | 466.1 |
| DiseasesDB | 1701 |
| MedlinePlus | 000975 |
| eMedicine | emerg/365 |
| MeSH | D001988 |
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Bronchiolitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Bronchiolitis On the Web |
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American Roentgen Ray Society Images of Bronchiolitis |
For the WikiPatient page for this topic, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Overview
Historical Perspective
Pathophysiology
Epidemiology & Demographics
Risk Factors
Screening
Causes
Differentiating Bronchiolitis
Complications & Prognosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory tests | Electrocardiogram | X Rays | CT | MRI Echocardiography or Ultrasound | Other images | Alternative diagnostics
Treatment
Medical therapy | Surgical options | Primary prevention | Secondary prevention | Financial costs | Future therapies
Treatment
There is no effective specific treatment for bronchiolitis. Therapy is principally supportive. Frequent small feeds are encouraged to maintain good urine output, and sometimes oxygen may be required to maintain blood oxygen levels. In severe cases the infant may need to be fed via a nasogastric tube or it may even need intravenous fluids. In extreme cases, mechanical ventilation (for example, using Continuous positive airway pressure (CPAP) might be necessary.
Bronchodilator drugs such as salbutamol/albuterol or ipratropium are no longer recommended, but many clinicians offer a trial dose to see if there is any benefit (especially if there is a family history of asthma, since it can be difficult to clinically distinguish bronchiolitis from a viral-induced wheeze). Racemic epinephrine is another drug that is sometimes given.
Ribavirin is an antiviral drug which has a controversial role in treating RSV infection. There is no proven benefit but it is used sometimes for infants with pre-existing lung, heart or immune disease. Antibiotics are often given in case of a bacterial infection complicating bronchiolitis, but have no effect on the underlying viral infection.
Corticosteroids have no proven benefit in bronchiolitis treatment and are not advised.
There is some interest in the use of hypertonic saline in bronchiolitis. Initially recommended for use in cystic fibrosis patients, it is speculated to increase hydration of secretions, thus facilitating their removal.
Prevention
In general, prevention of bronchiolitis relies on measures to reduce the spread of the viruses that cause respiratory infections (that is, handwashing, and avoiding exposure to those symptomatic with respiratory infections).
Premature infants, and others with certain majory cardiac and respiratory disorders, can receive passive immunization with Palivizumab (a monoclonal antibody against RSV). This form of passive immunization therapy requires monthly injections every winter. Whether it could benefit infants with lung problems secondary to muscular dystrophies and other vulnerable groups is currently unknown.
See also
External links
- Bronchiolitis. Patient information from NHS Direct
- Template:PDF from the Scottish Intercollegiate Guidelines Network
Template:Respiratory pathology
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