Clinical Review Bronchiolitis in children

Clinical Review Bronchiolitis in children

Bronchiolitis is the commonest cause of hospital attendance in infancy. It results in 20,000 hospital admissions annually,1 resulting in significant morbidity and even mortality. Virtual support groups will be available to bring parents and carers who want to access peer support together in a safe space. We know that caring for a little one with breathing difficulties can be overwhelming and exhausting at times.

  • 4) Even with histology, an adequate clinical, functional, radiological and histological correlation is required, since the findings may be common to several etiologies.
  • Children are more at risk of being admitted to hospital if they were born prematurely (before week 37 of pregnancy) or have an underlying health problem.
  • Use isotonic fluids (risk of SIADH) e.g. 0.9% saline and 5% dextrose or 0.9% saline and 10% dextrose in neonates +/- added KCL.
  • Bronchiolitis is a general term used to describe non-specific inflammatory injury that primarily affects the small airways and generally limits the extent to interstice.

Whilst treatment is primarily supportive, monoclonal antibodies against RSV are advocated for certain high risk groups (see Prophylaxis under Treatment). The incidence of bronchiolitis shows seasonal variation – peaking in winter. Approximately 30% of those infected with RSV express symptoms, and 3% require admission. Tobacco smoke and the vapours from e-cigarettes can make breathing more difficult.

When to get medical advice

If your child develops complications from bronchiolitis, it’s likely that they’ll need hospital treatment. Research also suggests that chest physiotherapy, where physical movements or breathing techniques are used to relieve the symptoms, is of no benefit. If your child cannot use nasogastric fluids, or they’re at high risk of respiratory failure, they may be given fluids directly into a vein (intravenously). If your child has RSV, they’ll need to be kept away from other children in the hospital who are not infected with the virus to stop it spreading.

  • Ibuprofen may be given to babies aged 3 months or over who weigh at least 5kg (11lbs).
  • In premature infants who have airway obstruction as a consequence of prematurity or its treatment, a lesser degree of airway inflammation can cause severe respiratory compromise.
  • Breast feeding is protective and smoking should be certainly discouraged.
  • Rheumatoid arthritis and other rheumatic diseases can lead to OB [7].

Supplemental oxygen and fluid support needs to be assessed as part of evaluation. Investigations required
Bronchiolitis is a clinical diagnosis; routine investigations should not be performed. We know seeing your baby being treated in hospital can be a very difficult experience. Parents and guardians that we’ve spoken to have described feeling “worried”, “scared” and having to “stand their ground” to have their child symptom’s taken seriously.


It’s also more likely to cause side effects, so is often only used alongside these medicines if they’re not effective enough. The effect of theophylline is weaker than other bronchodilators and corticosteroids. Theophylline is usually taken in tablet or capsule form, but a different version called aminophylline can be given directly into a vein (intravenously) if your symptoms are severe.

Passive smoking can affect the lining of your child’s airways, making them less resistant to infection. A small number of children will still have some symptoms after 4 weeks. In most cases, bronchiolitis is mild and gets better within 2 to 3 weeks without needing treatment.

About lung conditions

Several things can increase a child’s likelihood of developing the infection. Most cases of bronchiolitis are not serious, but the symptoms can be very worrying. The symptoms usually get worse during the next few days before gradually improving. Wheeze is a common symptom, however, it may be mistaken for other sounds such as stridor, snoring or congestion.

What causes bronchiolitis?

For example, antibiotics and corticosteroids aren’t recommended for treating bronchiolitis. A small plastic tube will be inserted into your child’s nostrils to suck out the mucus. Always follow the manufacturer’s instructions or check with your pharmacist before using saline nasal drops. Always follow the manufacturer’s instructions when giving your child medication.

Viewpoint: How we can address patients’ concerns about contraception

Bronchiolitis is a disease of the small airways, which are defined as airways with less than 2 mm in diameter and no cartilage [1]. Membranous bronchioles have full fibromuscular wall but this wall is very thin [2]. Bronchioles derived from the tertiary bronchus and form a transition area between the major airways and lung parenchyma and fundamentally have a centrilobular location.

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