What is the pathophysiology of bronchiolitis?

The pathophysiology of bronchiolitis begins with an acute infection of the epithelial cells lining the small airways within the lungs. Such infection results in edema, increased mucus production, and eventual necrosis and regeneration of these cells.

What is a bronchiolitis score?

The possible total score ranged from 0 to 10, with a higher score indicating more respiratory distress. A score of 0–3 represents a mildly ill infant, 4–6 moderately ill, and greater than 6 severely ill.

What is the treatment approach for bronchiolitis?

Relieving symptoms — There is no treatment that can get rid of bronchiolitis, so treatment is aimed at relieving symptoms until the infection resolves. Treatment at home usually includes making sure the child drinks enough and using saline nose drops (or bulb suctioning for infants) to keep the nose clear.

What is bronchiolitis RSV?

Bronchiolitis is a lung infection that’s usually caused by the respiratory syncytial virus (RSV), which produces swelling and mucus production in the small breathing tubes of your child’s lungs. Infections are most common during the winter and typically affect children under two years of age.

What is the common etiologic agent of bronchiolitis?

Most cases of bronchiolitis are caused by the respiratory syncytial virus (RSV). RSV is a common virus that infects just about every child by 2 years of age. Outbreaks of RSV infection occur every winter, and individuals can be reinfected, as previous infection does not appear to cause lasting immunity.

Does feeding infants with bronchiolitis on high flow nasal cannula lead to complications?

Conclusions: Our data supports that enteral feeding in patients with bronchiolitis on HFNC is safe.

What are substernal retractions?

Substernal or subcostal retractions: observed below the ribs at the junction between ribs and abdomen (Figure 1). They are cause by the abdominal muscle significantly contracting and revealing the edges of the rib cage.

Does nebulizer help bronchiolitis?

In severe cases, your doctor may elect to try a nebulized albuterol treatment to see if it helps. Oral corticosteroid medications and pounding on the chest to loosen mucus (chest physiotherapy) have not been shown to be effective treatments for bronchiolitis and are not recommended.

Is bronchiolitis worse at night?

Symptoms are often worse at night. Illness usually starts to improve after two to three days. Infection may be worse and last for longer in very young children (under three months), premature babies or children with lung or heart problems.

How long does it take for bronchiolitis to clear up?

Bronchiolitis is a common lower respiratory tract infection that affects babies and young children under 2 years old. Most cases are mild and clear up within 2 to 3 weeks without the need for treatment, although some children have severe symptoms and need hospital treatment.

Are there clinical pathways for bronchiolitis in children?

©2021 by Children’s Hospital of Philadelphia, all rights reserved. Use of this site is subject to the Terms of Use. The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication.

When to use CPAP in bronchiolitis emergency department?

If required FiO2 > 0.4 or continued severe distress despite increase to 2 L/kg/min / Max HFNC settings, initiate CPAP at 8 cm/0.4 Fio2 and consult PICU. If you have questions about any of the clinical pathways or about the process of creating a clinical pathway please contact us.

Is it safe to use a bronchodilator for bronchiolitis?

Bronchodilators not recommended for typical bronchiolitis. If used, document reason and response. Titrate to max settings using HFNC Job Aid. If you have questions about any of the clinical pathways or about the process of creating a clinical pathway please contact us.