Pediatric Bronchiolitis

Question 1

Bronchiolitis

Answer 1

Caused by viral low respiratory tract infection (RSV) in infants and young children

Acute inflammation, edema, increased mucus

Question 2

RSV

Answer 2

90% of children infected before 2 years of age

No long-term immunity–>re-infection common

Incubation period 2-8 days

Season: Nov-Apr

Question 3

RSV risk factors

Answer 3

Age < 6 months
Pre-term
CHD
Chronic lung disease
Weakened immune system

Question 4

Presentation

Answer 4

Cold-like symptoms

Increased work of breathing (nasal flaring, accessory breathing)

Symptoms peak around day 5

Question 5

SUPPORTIVE TREATMENT

Answer 5

Oxygen
hydration
mechanical vent
ECHMO (life support)

Question 6

Pharmacological

Answer 6

Flu vaccine: everyone ≥ 6 months
Children 6 mo – 8 years without 2 doses–> 2 doses separated by 4 weeks

Question 7

Nirsevimab

Answer 7

Who?
- Birth parent did not get Abrysvo at least 14 days before delivery
- Infants < 8 months
- Must be administered in RSV season

Dosing:
< 5 kg: 50 mg
≥ 5 kg: 100 mg
T1/2: 71 days

Question 8

Palivizumab

Question 9

Abrysvo

Answer 9

Maternal RSV vaccine

Administered before and during start of RSV season

32-26 weeks pregnant

Given at least 14 days before delivery