UP-TO DATE APPROACH TO ACUTE BRONCHIOLITIS

Abstract

Acute viral bronchiolitis is a very common disease of infancy, characterized by the respiratory distress caused usually by Respiratory Syncytial Virus (RSV). Lungs are diffusely affected and no spasm occurs in bronchial smooth muscles. High fever is unusual. Following rhinorrhea and coughing; prolonged expirium, tachypnea and respiratory distress occur. Diffuse wheezing is typical. Because of the risk of hypoxemia oxygen saturation must be closely followed and oxygen support should be provided if necessary. Patients are under the risk of dehydratation owing to insufficient oral intake. The diagnosis of acute bronchiolitis is based on the clinical findings, so laborotary studies are unnecessary. The main steps of the treatment are maintaining sufficent oxygenation, securing the liquid and electrolyte balance and drug therapy. Nebulized adrenalin can be partially helpful by reducing the airway edema. Nebulized salbutamol may be tried although its effect is questionable because of the absence of bronchospasm. However, it should not be continued if there is no benefit. The benefits of inhaled and oral corticosteroids are controversial. Antibiotics are unnecessary. The preventive measures include general infectious precautions, hand washing, environmental hygienic precautions, use of a mask if necessary, withholding sick kids from school, continuation of breastfeeding and preventing passive smoking. RSV vaccine is not available yet.