Bronchiolitis Flashcards
What is bronchiolitis?
Bronchiolitis is a condition characterised by acute bronchiolar inflammation.
What pathogen is responsible for most cases of bronchiolitis?
Respiratory syncytial virus (RSV) is the pathogen in 75-80% of cases.
When did NICE release guidelines on bronchiolitis?
NICE released guidelines on bronchiolitis in 2015.
What is the epidemiology of bronchiolitis in infants?
It is the most common cause of a serious lower respiratory tract infection in < 1yr olds, with 90% of cases in 1-9 months and a peak incidence of 3-6 months.
What provides protection to newborns against RSV?
Maternal IgG provides protection to newborns against RSV.
When is the incidence of bronchiolitis higher?
There is a higher incidence in winter.
What are other causes of bronchiolitis besides RSV?
Other causes include mycoplasma and adenoviruses.
What makes bronchiolitis more serious?
It is more serious if there is bronchopulmonary dysplasia, congenital heart disease, or cystic fibrosis.
What symptoms precede the features of bronchiolitis?
Coryzal symptoms (including mild fever) precede dry cough, increasing breathlessness, and wheezing.
What are common features of bronchiolitis?
Common features include dry cough, increasing breathlessness, wheezing, fine inspiratory crackles, and feeding difficulties.
What are the NICE recommendations for immediate referral in bronchiolitis?
Immediate referral is recommended if there is apnoea, the child looks seriously unwell, severe respiratory distress, central cyanosis, or persistent oxygen saturation of less than 92%.
What should clinicians consider for hospital referral in bronchiolitis?
Clinicians should consider referral if there is a respiratory rate over 60 breaths/minute, difficulty with breastfeeding, or clinical dehydration.
What investigation may show RSV in bronchiolitis?
Immunofluorescence of nasopharyngeal secretions may show RSV.
What is the management approach for bronchiolitis?
Management is largely supportive, including humidified oxygen, nasogastric feeding, and suction for excessive upper airway secretions.
When is humidified oxygen recommended in bronchiolitis management?
Humidified oxygen is recommended if the oxygen saturations are persistently < 92%.
