Diagnosis and management of bronchiolitis

被引:757
作者
Lieberthal, Allan S.
Bauchner, Howard
Hall, Caroline B.
Johnson, David W.
Kotagal, Uma
Light, Michael J.
Mason, Wilbert
Meissner, H. Cody
Phelan, Kieran J.
Zorc, Joseph J.
Brown, Mark A.
Clover, Richard D.
Nathanson, Ian T.
Korppi, Matti
Shiffman, Richard N.
Stanko-Lopp, Danette
Davidson, Caryn
机构
关键词
bronchiolitis;
D O I
10.1542/peds.2006-2223
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Bronchiolitis is a disorder most commonly caused in infants by viral lower respiratory tract infection. It is the most common lower respiratory infection in this age group. It is characterized by acute inflammation, edema, and necrosis of epithelial cells lining small airways, increased mucus production, and bronchospasm. The American Academy of Pediatrics convened a committee composed of primary care physicians and specialists in the fields of pulmonology, infectious disease, emergency medicine, epidemiology, and medical informatics. The committee partnered with the Agency for Healthcare Research and Quality and the RTI International-University of North Carolina Evidence-Based Practice Center to develop a comprehensive review of the evidence-based literature related to the diagnosis, management, and prevention of bronchiolitis. The resulting evidence report and other sources of data were used to formulate clinical practice guideline recommendations. This guideline addresses the diagnosis of bronchiolitis as well as various therapeutic interventions including bronchodilators, corticosteroids, antiviral and antibacterial agents, hydration, chest physiotherapy, and oxygen. Recommendations are made for prevention of respiratory syncytial virus infection with palivizumab and the control of nosocomial spread of infection. Decisions were made on the basis of a systematic grading of the quality of evidence and strength of recommendation. The clinical practice guideline underwent comprehensive peer review before it was approved by the American Academy of Pediatrics. This clinical practice guideline is not intended as a sole source of guidance in the management of children with bronchiolitis. Rather, it is intended to assist clinicians in decision-making. It is not intended to replace clinical judgment or establish a protocol for the care of all children with this condition. These recommendations may not provide the only appropriate approach to the management of children with bronchiolitis.
引用
收藏
页码:1774 / 1793
页数:20
相关论文
共 171 条
[11]   Breastfeeding and the risk of hospitalization for respiratory disease in infancy - A meta-analysis [J].
Bachrach, VRG ;
Schwarz, E ;
Bachrach, LR .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2003, 157 (03) :237-243
[12]   RIBAVIRIN AEROSOL FOR ACUTE BRONCHIOLITIS [J].
BARRY, W ;
COCKBURN, F ;
CORNALL, R ;
PRICE, JF ;
SUTHERLAND, G ;
VARDAG, A .
ARCHIVES OF DISEASE IN CHILDHOOD, 1986, 61 (06) :593-597
[13]   International variation in the management of infants hospitalized with respiratory syncytial virus [J].
Behrendt, CE ;
Decker, MD ;
Burch, DJ ;
Watson, PH .
EUROPEAN JOURNAL OF PEDIATRICS, 1998, 157 (03) :215-220
[14]  
Berger I, 1998, PEDIATR PULM, V26, P162, DOI 10.1002/(SICI)1099-0496(199809)26:3<162::AID-PPUL2>3.0.CO
[15]  
2-N
[16]   RESPIRATORY RATE AND PNEUMONIA IN INFANCY [J].
BERMAN, S ;
SIMOES, EAF ;
LANATA, C .
ARCHIVES OF DISEASE IN CHILDHOOD, 1991, 66 (01) :81-84
[17]  
BIERMAN CW, 1974, PEDIATRICS, V54, P245
[18]  
Bohe L, 2004, MEDICINA-BUENOS AIRE, V64, P198
[19]   Diagnosis and testing in bronchiolitis - A systematic review [J].
Bordley, WC ;
Viswanathan, M ;
King, VJ ;
Sutton, SF ;
Jackman, AM ;
Sterling, L ;
Lohr, KN .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2004, 158 (02) :119-126
[20]   Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force [J].
Boyce, JM ;
Pittet, D .
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2002, 23 (12) :S3-S40