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Bronchodilators in bronchiolitis

Eero Lauhkonen, Riikka Riikonen, Sari Törmänen, Petri Koponen, Kirsi Nuolivirta, Merja Helminen, Jyri Toikka, Matti Korppi
BACKGROUND: The transition from early childhood wheezing to persistent asthma is linked to lung function impairment over time. Little is known how the methods used to study lung function at different ages correlate longitudinally. METHODS: Sixty-four children with a history of hospitalization for bronchiolitis before 6 months of age were prospectively studied with impulse oscillometry (IOS) at the mean age of 6.3 years and these preschool IOS results were compared with flow-volume spirometry (FVS) measurements at mean age of 11...
February 27, 2018: Pediatric Pulmonology
Caili Guo, Xiaomin Sun, Xiaowen Wang, Qing Guo, Dan Chen
BACKGROUND: This study aims to compare placebo (PBO) and 7 therapeutic regimens-namely, bronchodilator agents (BAs), hypertonic saline (HS), BA ± HS, corticosteroids (CS), epinephrine (EP), EP ± CS, and EP ± HS-to determine the optimal bronchiolitis treatment. METHODS: We plotted networks using the curative outcome of several studies and specified the relations among the experiments by using mean difference, standardized mean difference, and corresponding 95% credible interval...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Fernando Ferrero, José A Castro Rodríguez
No abstract text is available yet for this article.
February 1, 2018: Archivos Argentinos de Pediatría
Yoshihiko Morikawa, Masaru Miura, Megumi Y Furuhata, Saeko Morino, Tae Omori, Masahiro Otsuka, Michiko Chiga, Toshimasa Obonai, Hiroshi Hataya, Tetsuji Kaneko, Kenji Ishikura, Masataka Honda, Yukihiro Hasegawa
INTRODUCTION: The efficacy of nebulized hypertonic saline (HS) therapy for shortening hospital length of stay (LOS) or improving bronchiolitic symptoms remains controversial. Most studies enrolled small numbers of subjects and did not consider the role of respiratory syncytial virus (RSV), the most common cause of acute bronchiolitis. Our aim was to evaluate the efficacy and safety of nebulized HS therapy for acute bronchiolitis due to RSV in moderately ill hospitalized infants. MATERIALS AND METHODS: This was an open-label, multicenter, randomized controlled trial comparing a nebulized HS treatment group with a normal saline (NS) group...
January 12, 2018: Pediatric Pulmonology
Grant M Mussman, Michele Lossius, Faiza Wasif, Jeffrey Bennett, Kristin A Shadman, Susan C Walley, Lauren Destino, Elizabeth Nichols, Shawn L Ralston
BACKGROUND AND OBJECTIVES: There is high variation in the care of acute viral bronchiolitis. We sought to promote collaboration between emergency department (ED) and inpatient (IP) units with the goal of reducing unnecessary testing and treatment. METHODS: Multisite collaborative with improvement teams co-led by ED and IP physicians and a 1-year period of active participation. The intervention consisted of a multicomponent change package, regular webinars, and optional coaching...
February 2018: Pediatrics
Ka-Ka Siu, Shuk-Yu Leung, Sum-Yi Kong, Daniel Kwok-Keung Ng
Preschool wheeze occurs in half of the children before they reach 6 y of age and recurrence is also common. Recurrent preschool wheeze is classified as either typical or atypical. For typical recurrent preschool wheeze, the diagnoses are either asthma or bronchiolitis/bronchitis. Responsiveness to a properly administered bronchodilator confirms asthma, atopic or otherwise. All atypical preschool wheeze should be referred to pediatric respirologist for assessment. Lung function test by impulse oscillometry (IOS) before and after bronchodilator is helpful to confirm airway hyperresponsiveness, an essential feature of asthma...
January 8, 2018: Indian Journal of Pediatrics
S Törmänen, E Lauhkonen, R Riikonen, P Koponen, H Huhtala, M Helminen, M Korppi, K Nuolivirta
BACKGROUND: Five studies carried out after bronchiolitis at less than 24 months of age, with a follow-up of more than 10 years, reported that atopic dermatitis, family asthma, early-life exposure to tobacco smoke and rhinovirus aetiology were early-life risk factors for later asthma. This study evaluated the long-term outcome at 11-13 years of age of children who were hospitalized for bronchiolitis in early infancy. METHODS: We previously prospectively followed 166 children hospitalized for bronchiolitis at less than 6 months of age until 5-7 years of age...
November 4, 2017: Allergy
Richard Breakell, Benjamin Thorndyke, Julie Clennett, Christian Harkensee
Chest X-rays (CXR), antibiotics and inhaled/nebulized therapy are overused in bronchiolitis, despite evidence-based guidelines suggesting supportive management only. This study investigates the effect of the implementation of the NICE bronchiolitis guideline in a secondary paediatric unit in England. We present a quality improvement project with a completed audit cycle (winter 2014-2015 and 2015-2016) pre- and post-implementation of the NICE bronchiolitis guideline. The educational intervention included sessions for raising awareness of appropriate and inappropriate management of bronchiolitis for both clinicians and nursing staff...
January 2018: European Journal of Pediatrics
Sonia Lorente, Rebeca Gimeno, Josep Maria Losilla, Sandra Garzón, Jaume Vives
BACKGROUND: There is no evidence to support the use of humidification in low-flow oxygen therapy as a usual clinical practice in the management of bronchiolitis. AIMS AND OBJECTIVES: To investigate the clinical benefits of using humidification in low-flow oxygen therapy. Specific objectives were to investigate via an assessment of the number of nasal lavages whether humidification can help to decrease the nasal mucus viscosity, to determine whether it can relieve feeding difficulties by comparing the weight gain in infants, to ascertain whether it can relieve respiratory distress by assessing the heart and respiratory rates and contribute to improved clinical outcomes, measured by the length of stay and oxygen requirements DESIGN: A controlled quasi-experimental study...
October 27, 2017: Journal of Clinical Nursing
Mario Reyes, Evan Paulus, Carla Hronek, Veronica Etinger, Matt Hall, Joyee Vachani, Jennifer Lusk, Christopher Emerson, Patty Huddleson, Ricardo A Quinonez
OBJECTIVES: In 2013, the Society of Hospital Medicine (SHM) released 5 pediatric recommendations for the Choosing Wisely Campaign (CWC). Our goals were to develop a report card on the basis of those recommendations, calculate achievable benchmarks of care (ABCs), and analyze performance among hospitals participating in the Pediatric Health Information System. METHODS: Children hospitalized between January 2013 and September 2015 from 32 Pediatric Health Information System hospitals were studied...
November 2017: Hospital Pediatrics
Jennifer Orr Vincent, Huay-Ying Lo, Susan Wu
BACKGROUND: Viral bronchiolitis is a common cause of hospitalization in young children, but despite a variety of therapeutic options, the mainstay of treatment remains supportive care. OBJECTIVE: To examine the most recent evidence for supportive care measures and pharmacologic options in the treatment of bronchiolitis in the hospital setting. METHOD: MEDLINE search with expert medical librarian for publications on management and therapies for bronchiolitis...
2017: Reviews on Recent Clinical Trials
J J Chai, T Liu, B Q Cai, H D Zhu
Objective: To analyze the clinical features of bronchiolitis obliterans syndrome (BOS) in patients with allogeneic hematopoietic stem cell transplantation (HSCT). Methods: This retrospective study included patients who underwent allogeneic HSCT from January 1998 to December 2016. The clinical features, radiological manifestations and treatment of clinically proven BOS were reviewed. Results: Of 681 patients who experienced HSCT, 10(1.47%) met the diagnostic criteria. The duration of BOS onset after transplantation was 5-48 months, averaging (18±15) months...
July 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
Kazuo Tsuchiya, Mikio Toyoshima, Yosuke Kamiya, Yutaro Nakamura, Satoshi Baba, Takafumi Suda
An 85-year-old, never-smoking man presented with exertional dyspnea. He had been exposed to silica dust in the work place. Chest computed tomography revealed bronchial wall thickening without emphysema. A pulmonary function test showed airflow obstruction without impaired gas transfer. Airway hyperresponsiveness and reversibility were not evident. A transbronchial lung biopsy showed findings suggestive of mineral dust exposure, such as fibrosis and slight pigmentation of bronchioles. He was diagnosed with non-smoking chronic obstructive pulmonary disease (COPD) due to occupational exposure to silica dust...
2017: Internal Medicine
I Chkhaidze, D Zirakishvili
Bronchiolitis is a common condition in children less than 2 years of age and is a leading cause of infant hospitalization. Acute bronchiolitis is characterized by acute wheezing in infants or children and is associated with signs or symptoms of respiratory infection; the most common etiologic agent is respiratory syncytial virus. There is a lack of consensus regarding the clinical definition of acute viral bronchiolitis in children and hence the management varies across the globe. Usually it does not require investigation, treatment is merely supportive and a conservative approach seems adequate in the majority of children, especially for the youngest ones...
March 2017: Georgian Medical News
Grant M Mussman, Rashmi D Sahay, Lauren Destino, Michele Lossius, Kristin A Shadman, Susan C Walley
BACKGROUND AND OBJECTIVES: Adoption of clinical respiratory scoring as a quality improvement (QI) tool in bronchiolitis has been temporally associated with decreased bronchodilator usage. We sought to determine whether documented use of a clinical respiratory score at the patient level was associated with a decrease in either the physician prescription of any dose of bronchodilator or the number of doses, if prescribed, in a multisite QI collaborative. METHODS: We performed a secondary analysis of data from a QI collaborative involving 22 hospitals...
May 2017: Hospital Pediatrics
Jose C Flores-González, Juan Mayordomo-Colunga, Iolanda Jordan, Alicia Miras-Veiga, Cristina Montero-Valladares, Marta Olmedilla-Jodar, Andrés J Alcaraz-Romero, Miren Eizmendi-Bereciartua, Francisco Fernández-Carrión, Carmen Santiago-Gutierrez, Esther Aleo-Luján, Sonia Pérez-Quesada, Cristina Yun-Castilla, Carmen Martín, Álvaro Navarro-Mingorance, Concha Goñi-Orayen
Objective. To determine the epidemiology and therapeutic management of patients with severe acute bronchiolitis (AB) admitted to paediatric intensive care units (PICUs) in Spain. Design. Descriptive, prospective, multicentre study. Setting. Sixteen Spanish PICUs. Patients. Patients with severe AB who required admission to any of the participating PICUs over 1 year. Interventions. Both epidemiological variables and medical treatment received were recorded. Results. A total of 262 patients were recruited; 143 were male (54...
2017: BioMed Research International
Marquita C Genies, Julia M Kim, Kristina Pyclik, Suzanne Rossi, Natalie Spicyn, Janet R Serwint
Bronchiolitis is the leading cause of infant hospitalizations in the United States. Despite clinical practice guidelines discouraging the utilization of non-evidence-based therapies, there continues to be wide variation in care and resource utilization. A pre-post physician focused educational intervention was conducted with the aims to reduce the use of non-evidence-based medical therapies, including bronchodilators, among patients admitted for bronchiolitis. Among patients meeting inclusion criteria (pre: n = 45; post: n = 47), bronchodilator use decreased by 50% ( P < ...
April 1, 2017: Clinical Pediatrics
Khalid Alansari, Rafah Sayyed, Bruce L Davidson, Shahaza Al Jawala, Mohamed Ghadier
BACKGROUND: The goal of this study was to determine if IV magnesium, useful for severe pediatric asthma, reduces time to medical readiness for discharge in patients with bronchiolitis when added to supportive care. METHODS: We compared a single dose of 100 mg/kg of IV magnesium sulfate vs placebo for acute bronchiolitis. Patients received bronchodilator therapy, nebulized hypertonic saline, and 5 days of dexamethasone if there was eczema and/or a family history of asthma...
July 2017: Chest
S Adhikari, P Thapa, K S Rao, G Bk
Background Acute bronchiolitis is common cause of hospitalization in infants and young children. There are widespread variations in the diagnosis and management. Despite the use of bronchodilators for decades, there is lack of consensus for the benefit of one above another. Objective To compare initial response of nebulized adrenaline and salbutamol. Method Children aged two months to two years admitted with acute bronchiolitis in the department of Paediatrics of Manipal teaching hospital, Pokhara, Nepal, from 1st March 2014 to 28th February 2015 were enrolled...
January 2016: Kathmandu University Medical Journal (KUMJ)
Uzma Bashir, Nadia Nisar, Yasir Arshad, Muhammad Masroor Alam, Asiya Ashraf, Hajra Sadia, Birjees Mazher Kazi, Syed Sohail Zahoor Zaidi
Pneumonia remains a leading cause of morbidity and mortality in developing countries. Comprehensive surveillance data are needed to review the prevention and control strategies. We conducted active surveillance of acute lower respiratory infections among children aged <2 years hospitalized at two hospitals of Islamabad, Pakistan. Viral etiology was determined using real-time PCR on respiratory specimens collected during March 2011-April 2012. The overall mean age was 7.83 ± 5.25 months while no statistical difference between age or sex distribution of patients with positive and negative viral etiology (p > 0...
March 2017: Archives of Virology
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