Acute Viral Bronchiolitis: A Narrative Review

Suresh K. Angurana; Vijai Williams; Lalit Takia

doi:10.1055/s-0040-1715852

Journal of Pediatric Intensive Care, Table of Contents

J Pediatr Intensive Care 2023; 12(02): 079-086
DOI: 10.1055/s-0040-1715852

Review Article

Acute Viral Bronchiolitis: A Narrative Review

Suresh K. Angurana

¹Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

,

Vijai Williams

²Pediatric Intensive Care Unit, Gleneagles Global Hospitals, Perumbakkam, Chennai, India

,

Lalit Takia

¹Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

› Author Affiliations

Abstract

Acute viral bronchiolitis (AVB) is the leading cause of hospital admissions among infants in developed and developing countries and associated with increased morbidity and cost of treatment. This review was performed to guide the clinicians managing AVB in light of evidence accumulated in the last decade. We searched published English literature in last decade regarding etiology, diagnosis, treatment, and prevention of AVB using PubMed and Cochrane Database of Systematic Reviews. Respiratory syncytial virus is the most common causative agent. The diagnosis is mainly clinical with limited role of diagnostic investigations and chest radiographs are not routinely indicated. The management of AVB remains a challenge, as the role of various interventions is not clear. Supportive care in form of provision of heated and humidified oxygen and maintaining hydration are main interventions. The use of pulse oximetry helps to guide the administration of oxygen. Trials and systematic reviews evaluated various interventions like nebulized adrenaline, bronchodilators and hypertonic saline, corticosteroids, different modes of noninvasive ventilation (high-flow nasal cannula [HFNC], continuous positive airway pressure [CPAP], and noninvasive positive pressure ventilation [NPPV]), surfactant, heliox, chest physiotherapy, and antiviral drugs. The interventions which showed some benefits in infants and children with AVB are adrenaline and hypertonic saline nebulization, HFNC, CPAP, NIV, and surfactant. The routine administration of antibiotics, bronchodilators, corticosteroids, steam inhalation, chest physiotherapy, heliox, and antiviral drugs are not recommended.

Keywords

respiratory syncytial virus - hypertonic saline - HFNC - nebulization - wheezing

Full Text

References

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