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Bronchodilators in bronchiolitis

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https://www.readbyqxmd.com/read/29105099/risk-factors-for-asthma-after-infant-bronchiolitis
#1
S Törmänen, E Lauhkonen, R Riikonen, Petri 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 hospitalised for bronchiolitis in early infancy. METHODS: We previously prospectively followed 166 children hospitalised for bronchiolitis at less than six months of age until 5-7 years of age...
November 4, 2017: Allergy
https://www.readbyqxmd.com/read/29080051/reducing-unnecessary-chest-x-rays-antibiotics-and-bronchodilators-through-implementation-of-the-nice-bronchiolitis-guideline
#2
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...
October 28, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29076616/benefits-of-the-humidified-low-flow-oxygen-therapy-in-infants-with-mild-moderate-bronchiolitis
#3
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
https://www.readbyqxmd.com/read/29066468/choosing-wisely-campaign-report-card-and-achievable-benchmarks-of-care-for-children-s-hospitals
#4
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...
October 24, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28814254/bronchiolitis-care-in-the-hospital
#5
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 Methods: MEDLINE search with expert medical librarian for publications on management and therapies for bronchiolitis Results: Evidence does not support the use of bronchodilators, racemic epinephrine, deep suctioning, systemic corticosteroids, or antibiotics in the absence of a concomitant bacterial infection, as these treatments do not change the course of illness or shorten length of stay (LOS)...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28728274/-a-retrospective-study-of-10-cases-of-post-transplant-bronchiolitis-obliterans
#6
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
https://www.readbyqxmd.com/read/28674361/non-smoking-chronic-obstructive-pulmonary-disease-attributed-to-occupational-exposure-to-silica-dust
#7
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
https://www.readbyqxmd.com/read/28480848/acute-viral-bronchiolitis-in-infants-review
#8
REVIEW
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
https://www.readbyqxmd.com/read/28442541/respiratory-scores-as-a-tool-to-reduce-bronchodilator-use-in-children-hospitalized-with-acute-viral-bronchiolitis
#9
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/28421191/prospective-multicentre-study-on-the-epidemiology-and-current-therapeutic-management-of-severe-bronchiolitis-in-spain
#10
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/28420262/impact-of-an-educational-intervention-to-improve-physician-adherence-to-bronchiolitis-clinical-practice-guidelines-a-pre-post-intervention-study
#11
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
https://www.readbyqxmd.com/read/28286262/iv-magnesium-sulfate-for-bronchiolitis-a-randomized-trial
#12
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/27892438/comparison-of-initial-response-of-nebulized-salbutamol-and-adrenaline-in-infants-and-young-children-admitted-with-acute-bronchiolitis
#13
COMPARATIVE STUDY
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)
https://www.readbyqxmd.com/read/27885562/respiratory-syncytial-virus-and-influenza-are-the-key-viral-pathogens-in-children-2%C3%A2-years-hospitalized-with-bronchiolitis-and-pneumonia-in-islamabad-pakistan
#14
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
https://www.readbyqxmd.com/read/27743492/respiratory-reactance-in-children-aged-three-to-five%C3%A2-years-with-postinfectious-bronchiolitis-obliterans-is-higher-than-in-those-with-asthma
#15
Eun Lee, Jisun Yoon, Hyun-Ju Cho, Soo-Jong Hong, Jinho Yu
AIM: We investigated airway function in preschoolers with postinfectious bronchiolitis obliterans (PIBO) using impulse oscillometry (IOS). METHODS: This study enrolled 182 children aged three to five years: 12 with PIBO, 135 with asthma and 35 nonatopic controls. Respiratory resistance and reactance were assessed using IOS. RESULTS: The percentage predicted (% predicted) of prebronchodilator respiratory resistance at 5 Hz was significantly higher in children with PIBO (177...
January 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/27650524/bronchiolitis-in-young-infants-is-it-a-risk-factor-for-recurrent-wheezing-in-childhood
#16
Firas Rinawi, Imad Kassis, Rina Tamir, Amir Kugelman, Isaac Srugo, Dan Miron
BACKGROUND: Acute bronchiolitis in infancy is considered a risk factor for recurrent wheezing episodes in childhood. The present study assessed prevalence, clinical manifestations and risk factors for recurrent wheezing events during the first 3 years of life and persistent wheezing events beyond this age in children hospitalized as young infants with acute bronchiolitis. METHODS: Two groups of children aged 6 years were included. The study group comprised 150 children with a history of hospitalization for bronchiolitis, with the first event at <6 months of age...
February 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/27603231/role-of-endogenous-hydrogen-sulfide-in-nerve-evoked-relaxation-of-pig-terminal-bronchioles
#17
Vítor S Fernandes, Paz Recio, Elvira López-Oliva, María Pilar Martínez, Ana Sofía Ribeiro, María Victoria Barahona, Ana Cristina Martínez, Sara Benedito, Ángel Agis-Torres, Alberto Cabañero, Gemma M Muñoz, Albino García-Sacristán, Luis M Orensanz, Medardo Hernández
Hydrogen sulfide (H2S) is a gasotransmitter employed for intra- and inter-cellular communication in almost all organ systems. This study investigates the role of endogenous H2S in nerve-evoked relaxation of pig terminal bronchioles with 260 μm medium internal lumen diameter. High expression of the H2S synthesis enzyme cystathionine γ-lyase (CSE) in the bronchiolar muscle layer and strong CSE-immunoreactivity within nerve fibers distributed along smooth muscle bundles were observed. Further, endogenous H2S generated in bronchiolar membranes was reduced by CSE inhibition...
December 2016: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27549684/viral-bronchiolitis
#18
REVIEW
Todd A Florin, Amy C Plint, Joseph J Zorc
Viral bronchiolitis is a common clinical syndrome affecting infants and young children. Concern about its associated morbidity and cost has led to a large body of research that has been summarised in systematic reviews and integrated into clinical practice guidelines in several countries. The evidence and guideline recommendations consistently support a clinical diagnosis with the limited role for diagnostic testing for children presenting with the typical clinical syndrome of viral upper respiratory infection progressing to the lower respiratory tract...
January 14, 2017: Lancet
https://www.readbyqxmd.com/read/27472490/following-up-infant-bronchiolitis-patients-provided-new-evidence-for-and-against-the-united-airway-disease-hypothesis
#19
Eero Lauhkonen, Petri Koponen, Kirsi Nuolivirta, Merja Helminen, Marita Paassilta, Jyri Toikka, Matti Korppi
AIM: The united airway disease (UAD) hypothesis suggests that allergic rhinitis and asthma develop together. We evaluated the evidence for and against the UAD hypothesis at five to seven years of age after hospitalisation for bronchiolitis at less than six months. METHODS: This study used prospective follow-up data for 102 children hospitalised for bronchiolitis under the age of six months. We included the presence of previous and current asthma, prolonged rhinitis and skin prick tests (SPT) to common inhaled allergens and lung function by impulse oscillometry (IOS) at five to seven years of age...
November 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27402352/what-works-to-reduce-unnecessary-care-for-bronchiolitis-a-qualitative-analysis-of-a-national-collaborative
#20
Shawn L Ralston, Emily Carson Atwood, Matthew D Garber, Alison Volpe Holmes
OBJECTIVE: Unnecessary care is well established as a quality problem affecting acute viral bronchiolitis, one of the most common pediatric illnesses. Although there is an extensive quality improvement literature on the disease, published work primarily reflects the experience of freestanding children's hospitals. We sought to better understand the specific barriers and drivers for successful quality improvement in community and nonfreestanding children's facilities. METHODS: We undertook a mixed methods study to identify correlates of success in a bronchiolitis quality improvement collaborative of community hospitals and children's hospitals within adult hospitals...
March 2017: Academic Pediatrics
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