7.2 Bronchiolitis Flashcards
What is bronchiolitis?
- First episode of wheezing with findings of viral rep infection
- no pneumonia/atopy
Age for bronchiolitis?
12-24 months
Bronchiolitis cause?
RSV
Bronchiolitis peak time?
Winter
Other viruses that cause Bronchiolitis?
Rhino, parainfluenza, influenza, adenovirus, coronavirus
Pathogenesis of Bronchiolitis?
- Small airways inflammation
- Peribronchiolar infiltration, necrosis, biliary disruption
- aedema, excess mucus
- Obstruction/atelectasis
DDx for Bronchiolitis?
Asthma Heart failure Chlamydia Pneumonia Foreign body Pertussis Pneumothorax Aspiration
Risk factors for Bronchiolitis?
<37 gestational age <10 weeks old Cigarette smoke Breast fed for <2 months Failure to thrive Chronic lung and heart disease Neurological conditions Indigenous
What is mild Bronchiolitis?
Still feeding
No need for 02 (>92%)
No Resp distress
Often febrile
What is moderate Bronchiolitis?
- SOB while feeding
- Mod distress, retractions
- Brief apnoea can episodes
- mild hypoxaemia, corrected by O2
Bronchiolitis severe?
- Can’t feed
- severe resp distress
- Hypoxaemia not corrected by O2
- Prolonged apnoea episodes
Mx of Bronchiolitis?
Supportive
Hydration
O2 CPAP/NIV
Fluids for Bronchiolitis severe?
usually IV
Fluids for moderate Bronchiolitis?
Frequent small
NG
Bronchiolitis d/c criteria?
Minimal distress with feeding
Sp02 >92%
Parents happy/informed
Other associated infections with bronchiolitis?
Acute otitis media
UTI
Which kids who have bronchiolitis have recurrent wheezy episodes at one/five year?
Hospitalised kids
How to prevent?
Avoid smoking
Breast feed
Immunoprophylaxis for high risk kids
High flow nasal cannula therapy for bronchiolitis?
Used, but evidence is limited
Nebuliser hypertonic saline for bronchiolitis?
Not really
