Until 2014 a mainstay of management of bronchiolitis involved the administration of inhaled bronchodilators. Evaluation of several agents demonstrated a potential slight improvement of respiratory distress symptoms but no long-term benefits (for example, duration of symptoms, shortening of the need for supplemental oxygen, etc.). Because there are children who have asthma exacerbations during the bronchiolitis season, some centers will provide a single inhalation bronchodilator therapy treatment. Should a substantial improvement be demonstrated, a consideration of further similar therapy can be considered. Children who do not demonstrate such an improvement need no further inhaled bronchodilators. Chest physiotherapy has not been demonstrated to be of benefit for pulmonary symptoms and is thus not recommended.
Bronchiolitis is a common cause of illness and is the leading cause of hospitalization in infants and young children. Treatment includes measures to ensure that the child consumes adequate fluids and is able to breathe without significant difficulty. Most children begin to improve two to five days after first developing breathing difficulties, but wheezing can last for a week or longer. Bronchiolitis can cause serious illness in some children. Infants who are very young, born early, have lung or heart disease, or have difficulty fighting infections or handling oral secretions are more likely to have severe disease with bronchiolitis. It is important to be aware of the signs and symptoms that require evaluation and treatment.
1. Paediatric Society of New Zealand. (2005). “Best Practice Evidence Based Guideline: Wheeze and Chest Infection in Infants Under 1 Year”. The Society.
2. Papadopoulos NG; Moustaki M; Tsolia M; Bossios A; Astra E; Prezerakou A (2002). Am J Respir Crit Care Med.
3. American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics 2006; 118:1774.
4. Scottish Intercollegiate Guidelines Network. Bronchiolitis in children. A national clinical guideline. 2006. http:///pdf/