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Systematic reviews and acute bronchiolitis

Gonzalo Alarcón-Andrade, Lorena Cifuentes
INTRODUCTION: Bronchiolitis is an acute small airways inflammation mainly caused by a viral infection. It is frequent in children under two years of age, particularly under 12 months. The use of systemic corticosteroids has been proposed for bronchiolitis, especially for severely ill patients. However, its efficacy is still controversial. METHODS: To answer this question we gathered information using Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others...
May 7, 2018: Medwave
Anne B Chang, John J Oppenheimer, Bruce K Rubin, Miles Weinberger, Richard S Irwin
BACKGROUND: Acute bronchiolitis is common in young children and some children develop chronic cough after their bronchiolitis. We thus undertook systematic reviews based on key questions (KQs) using the PICO format. The KQs were: Among children with chronic cough (>4 weeks) after acute viral bronchiolitis, how effective are the following interventions in improving the resolution of cough?: (1) Antibiotics. If so what type and for how long? (2) Asthma medications (inhaled steroids, beta2 agonist, montelukast) and; (3) Inhaled osmotic agents like hypertonic saline? METHODS: We used the CHEST expert cough panel's protocol and the American College of Chest Physicians (CHEST) methodological guidelines and GRADE framework...
April 25, 2018: Chest
Gonzalo Alarcón-Andrade, Lorena Cifuentes
INTRODUCTION: Bronchiolitis consists of an acute small airways inflammation secondary to a viral infection and is a frequent pathology among children under 2 years. The use of inhaled corticosteroids during bronchiolitis has been proposed to reduce recurrent wheeze or asthma, however there is controversy about it. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others...
April 17, 2018: Medwave
Mauricio T Caballero, Fernando P Polack, Renato T Stein
OBJECTIVE: The aim of this review was to address advances in management and treatment of acute viral bronchiolitis in infants. SOURCES: A systematic review search was made including all articles published in English between 2010 and 2017, and available in the electronic databases PubMed and Cochrane Central Register of Controlled Trials (CENTRAL) and specialized register of the Acute Respiratory Infections Group (Cochrane review group). The following MESH terms in English were included, using different Boolean operators for the search strategy: "bronchiolitis, viral," "diagnosis," "epidemiology," "etiology," "therapy," "virology," "prevention and control," "respiratory syncytial virus, human...
November 2017: Jornal de Pediatria
Melissa A Hilmes, F Daniel Dunnavant, Sudha P Singh, Wendy D Ellis, Daniel C Payne, Yuwei Zhu, Marie R Griffin, Kathryn M Edwards, John V Williams
BACKGROUND: Human metapneumovirus (HMPV) was identified in 2001 and is a common cause of acute respiratory illness in young children. The radiologic characteristics of laboratory-confirmed HMPV acute respiratory illness in young children have not been systematically assessed. OBJECTIVE: We systematically evaluated the radiographic characteristics of acute respiratory illness associated with HMPV in a prospective cohort of pediatric patients. MATERIALS AND METHODS: We included chest radiographs from children <5 years old with acute respiratory illness who were enrolled in the prospective New Vaccine Surveillance Network (NVSN) study from 2003 to 2009 and were diagnosed with HMPV by reverse transcription-polymerase chain reaction (RT-PCR)...
December 2017: Pediatric Radiology
Kok P Kua, Shaun W H Lee
Objective: To evaluate the effectiveness of combined epinephrine and corticosteroid therapy for acute bronchiolitis in infants. Methods: Four electronic databases (MEDLINE, EMBASE, CINAHL, and CENTRAL) were searched from their inception to February 28, 2017 for studies involving infants aged less than 24 months with bronchiolitis which assessed the use of epinephrine and corticosteroid combination therapy. The methodological quality of the included studies was assessed using the Cochrane Collaboration's Risk of Bias Tool...
2017: Frontiers in Pharmacology
Nnenna O Chime, Jessica Katznelson, Sandeep Gangadharan, Barbara Walsh, Katie Lobner, Linda Brown, Marcie Gawel, Marc Auerbach
OBJECTIVE: Acutely ill infants and children presenting to the emergency department are treated by either physicians with pediatric emergency medicine (PEM) training or physicians without PEM training, a good proportion of which are general emergency medicine-trained physicians (GEDPs). This scoping review identified published literature comparing the care provided to infants and children (≤21 years of age) by PEM-trained physicians to that provided by GEDPs. METHODS: The search was conducted in 2 main steps as follows: (1) initial literature search to identify available literature with evolving feedback from the group while simultaneously deciding search concepts as well as inclusion and exclusion criteria and (2) modification of search concepts and conduction of search using finalized concepts as well as review and selection of articles for final analysis using set inclusion criteria...
April 2017: Pediatric Emergency Care
Yann Combret, Guillaume Prieur, Pascal LE Roux, Clément Médrinal
INTRODUCTION: Non-invasive ventilation (NIV) is a common treatment for bronchiolitis. However, consensus concerning its efficacy is lacking. The aim of this systematic review was to assess NIV effectiveness to reduce respiratory distress. Secondary objectives were to summarize the effects of NIV, identify predictive factors for failure and describe settings and applications. EVIDENCE ACQUISITION: Literature searches were conducted in MEDLINE/PubMed, PEDro, Cochrane, EMBASE, CINAHL, Web of Science, UpToDate, and SuDoc from 1990 to April 2015...
June 2017: Minerva Anestesiologica
Patricia Green, Stephen C Aronoff, Michael DelVecchio
Background. Acute bronchiolitis infection during infancy is associated with an increased risk of asthma later in life. The objective of this study was to determine if inhaled steroids are effective in preventing the development of recurrent wheeze or asthma following acute bronchiolitis. Methods. Multiple databases and bibliographies of selected references were searched. Inclusion required (a) a randomized controlled trial of inhaled steroids and control group, (b) at least 2 weeks duration of therapy started during the acute phase of disease, and (c) identification of the rate of recurrent wheeze or asthma at least 6 months after therapy...
2015: Global Pediatric Health
Catherine H Miele, Kristin Schwab, Rajeev Saggar, Erin Duffy, David Elashoff, Chi-Hong Tseng, Sam Weigt, Deepshikha Charan, Fereidoun Abtin, Jimmy Johannes, Ariss Derhovanessian, Jeffrey Conklin, Kevin Ghassemi, Dinesh Khanna, Osama Siddiqui, Abbas Ardehali, Curtis Hunter, Murray Kwon, Reshma Biniwale, Michelle Lo, Elizabeth Volkmann, David Torres Barba, John A Belperio, David Sayah, Thomas Mahrer, Daniel E Furst, Suzanne Kafaja, Philip Clements, Michael Shino, Aric Gregson, Bernard Kubak, Joseph P Lynch, David Ross, Rajan Saggar
RATIONALE: Consideration of lung transplantation in patients with systemic sclerosis (SSc) remains guarded, often due to the concern for esophageal dysfunction and the associated potential for allograft injury and suboptimal post-lung transplantation outcomes. OBJECTIVES: The purpose of this study was to systematically report our single-center experience regarding lung transplantation in the setting of SSc, with a particular focus on esophageal dysfunction. METHODS: We retrospectively reviewed all lung transplants at our center from January 1, 2000 through August 31, 2012 (n = 562), comparing the SSc group (n = 35) to the following lung transplant diagnostic subsets: all non-SSc (n = 527), non-SSc diffuse fibrotic lung disease (n = 264), and a non-SSc matched group (n = 109)...
June 2016: Annals of the American Thoracic Society
(no author information available yet)
No abstract text is available yet for this article.
April 2016: Pediatrics
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
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
Carlos E Rodriguez-Martinez, Monica P Sossa-Briceño, Ranniery Acuña-Cordero
RATIONALE, AIMS AND OBJECTIVES: Recently, in an attempt to reduce variability in clinical practice and produce better results for patients, several clinical practice guidelines (CPGs) for the appropriate diagnosis and management of bronchiolitis in infants have been developed. However, the quality of available CPGs for bronchiolitis management has not yet been systematically evaluated. The aim of this study was to assess the quality of acute viral bronchiolitis CPGs. METHOD: We performed a systematic and exhaustive search of CPGs on bronchiolitis published from 2000 to 2014...
February 2017: Journal of Evaluation in Clinical Practice
Mark L Everard, Daniel Hind, Kelechi Ugonna, Jennifer Freeman, Mike Bradburn, Simon Dixon, Chin Maguire, Hannah Cantrill, John Alexander, Warren Lenney, Paul McNamara, Heather Elphick, Philip Aj Chetcuti, Eduardo F Moya, Colin Powell, Jonathan P Garside, Lavleen Kumar Chadha, Matthew Kurian, Ravinderjit S Lehal, Peter I MacFarlane, Cindy L Cooper, Elizabeth Cross
BACKGROUND: Acute bronchiolitis is the most common cause of hospitalisation in infancy. Supportive care and oxygen are the cornerstones of management. A Cochrane review concluded that the use of nebulised 3% hypertonic saline (HS) may significantly reduce the duration of hospitalisation. OBJECTIVE: To test the hypothesis that HS reduces the time to when infants were assessed as being fit for discharge, defined as in air with saturations of > 92% for 6 hours, by 25%...
August 2015: Health Technology Assessment: HTA
Robert G Badgett, Mohinder Vindhyal, Jason T Stirnaman, C Michael Gibson, Rim Halaby
No abstract text is available yet for this article.
August 2015: JAMA Pediatrics
Jose A Castro-Rodriguez, Carlos E Rodriguez-Martinez, Monica P Sossa-Briceño
Bronchiolitis is the most common cause of hospitalization among infants during the first 12 months of life, with high direct and indirect cost for health system and families. Different treatment approaches co-exist worldwide resulting in many drugs prescribed, without any proven benefit. Twenty systematic reviews of randomized clinical trials (SRCTs) on management of acute bronchiolitis in children were retrieved through 5 databases and their methodological quality was determined using an AMSTAR tool. Epinephrine showed impact only in short-term outcomes among outpatients (reduced admission at day 1 and improved the clinical score in the first 2 hours, compared to placebo) and inpatients (decreased length of stay (LOS) and improved saturation only in the first 2 hours, compared to nebulized salbutamol, but with high heterogeneity)...
September 2015: Paediatric Respiratory Reviews
B Sterling, E Bosdure, N Stremler-Le Bel, B Chabrol, J-C Dubus
Every winter, numerous infants are hospitalized for acute bronchiolitis. The severity criteria and symptomatic treatment are well known, with chest physiotherapy codified in 2000 by the French Health Authority (HAS) consensus conference (with techniques varying from one country to another) and becoming nearly systematic for the treatment of bronchial obstruction in infants. However, is this treatment really effective and legitimate for acute bronchiolitis? The objective of this study was to review the main studies on this subject...
January 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Lisa Hartling, Ben Vandermeer, Ricardo M Fernandes
BACKGROUND: The Cochrane Collaboration has been at the forefront of developing methods for knowledge synthesis internationally. OBJECTIVES: We discuss three approaches to synthesize evidence for healthcare interventions: systematic reviews (SRs), overviews of reviews and comparative effectiveness reviews. METHODS: We illustrate these approaches with examples from knowledge syntheses on interventions for bronchiolitis, a common acute paediatric condition...
June 2014: Evidence-based Child Health: a Cochrane Review Journal
Ricardo M Fernandes, Marta Oleszczuk, Charles R Woods, Brian H Rowe, Christopher J Cates, Lisa Hartling
BACKGROUND: Acute respiratory conditions are a leading cause of childhood morbidity and mortality. Corticosteroids are effective and established treatments in some acute respiratory infections (e.g. croup) and asthma exacerbations; however, their role is controversial in other conditions owing to inconsistent effectiveness or safety concerns (e.g. bronchiolitis, acute wheeze). OBJECTIVES: To examine clinically relevant short-term safety outcomes related to acute single or recurrent systemic short-term (<2 weeks) corticosteroid use based on systematic reviews of acute respiratory conditions...
September 2014: Evidence-based Child Health: a Cochrane Review Journal
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