Diagnosis, treatment, and prevention — three key attributes in managing bronchiolitis — were addressed in a revision of the 2006 guidelines from the American Academy of Pediatrics concerning bronchiolitis management. The report, “Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis,” involved a number of MDs, FAAPs, PhDs, FACMIs, MSCEs, MPHs, FACEPs, and JDs, giving merit to these updated guidelines.
According to a report from the AAP, “New Data Prompt Update to AAP Guideline on Diagnosis, Management of Bronchiolitis,” great emphasis is placed on the fact that bronchiolitis is a clinical diagnosis. It is caused by a number of viruses, and up to 30% of patients experience infection by more than one virus. As such, a test for respiratory syncytial virus (RSV) or other viruses is not important for diagnosis, and neither are chest radiography or blood counts.
The new recommendations also stress that bronchiodilators, corticosteroids, and chest physiotherapy should not be used for treating bronchiolitis. A great number of studies suggest the ineffectiveness of these therapies in altering the clinical course of disease. In contrast, although there was not a recommendation for or against nebulized hypertonic saline, the AAP recognizes the treatment as potentially shortening hospitalization periods.
Hydration was one “treatment” supported by the guidelines. Patients should be hydrated via intravenous or nasogastric routes. Additionally, hygiene is important, both for the patient and for anyone who comes in contact with the patient or inanimate objects within the vicinity of the patient.
A final note concerning treatment was the use of palivizumab. The drug should not be given to otherwise healthy infants, but it can be administered to infants who show signs of hemodynamically significant heart disease or chronic lung disease.
These guidelines will continue to aid clinicians in treating their patients with bronchiolitis. These staff members should be educated with these guidelines in a “warm and personal manner.”