What is bronchiolitis? Cause and age group affected?
Inflammation and infection of bronchioles
Most common cause is RSV
Children under 1 year
Presentation of bronchiolitis
Coryzal symptoms Dyspnoea Tachypnoea Signs of respiratory distress - e.g. use of accessory muscles Poor feeding Mild feeding Apnoea Wheeze and crackles on auscultation
Typical course of RSV bronchiolitis
Symptoms usually last 7-10 days total and most patients fully recover within 2-3w
Symptoms usually worst on days 3-4
When to admit in bronchiolitis
Aged under 3 months or any pre-existing condition such as prematurity, Downs syndrome or cystic fibrosis
50 – 75% or less of normal food intake
Clinical dehydration
Respiratory rate above 70
Oxygen saturations below 92%
Moderate to severe
respiratory distress, such as deep recessions or head bobbing
Apnoeas
Management of bronchiolitis
Supportive
Ensuring adequate intake -e.g. IV fluids, NG tube
Supplementary oxygen if sats <92%
May need nasal suctioning to clear nasal secretions
What can be used as bronchiolitis prophylaxis and when used?
Palivizumab - monthly monoclonal antibody injection that targets RSV
Given to high risk babies - e.g. premature or congenital heart disease
