Women's and Child's Health Department, Unit of Pediatric Respiratory Medicine and Allergy, Unit of Pediatric Emergency Department, University of Padova, Via Giustiniani 3, Padua,Italy.
Early Hum Dev. 2013 Jun;89 Suppl 1:S31-6. doi: 10.1016/S0378-3782(13)70011-2.
Bronchiolitis is a leading cause of acute illness and hospitalization for infants and young children worldwide. It is usually a mild disease, but the few children developing severe symptoms need to be hospitalized and some will need ventilatory support. To date, the mainstay of therapy has been supportive care, i.e. assisted feeding and hydration, minimal handling, nasal suctioning and oxygen therapy. In recent years the delivery of oxygen has been improved by using a high-flow nasal cannula. At the same time, the discovery of nebulized hypertonic saline enables better airway cleaning with a benefit for respiratory function. The possible role of any pharmacological approach is still debated: many pharmacological therapies tried in the past, ranging from bronchodilators to corticosteroids, were found to offer no benefit in this disease. More recently, nebulized adrenaline demonstrated a short-term benefit. Prophylaxis and prevention, especially in children at high risk of severe infection, such as prematurely born infants and children with bronchopulmonary dysplasia, have a fundamental role in dealing with this disease. In this review, we focus on current recommendations for the management and prevention of bronchiolitis, paying particular attention to the latest literature in search of answers to the questions that remain open.
毛细支气管炎是全球婴幼儿急性疾病和住院的主要原因。它通常是一种轻度疾病，但少数出现严重症状的儿童需要住院治疗，有些则需要呼吸机支持。迄今为止，治疗的主要方法是支持性护理，即辅助喂养和补液、尽量少处理、鼻腔抽吸和氧疗。近年来，通过使用高流量鼻导管改善了供氧。与此同时，发现雾化高渗盐水可以更好地清洁气道，改善呼吸功能。任何药物治疗方法的可能作用仍存在争议：过去尝试的许多药物治疗方法，从支气管扩张剂到皮质类固醇，在这种疾病中均未显示出获益。最近，雾化肾上腺素显示出短期获益。预防和预防，特别是对有严重感染高风险的儿童，如早产儿和患有支气管肺发育不良的儿童，在处理这种疾病方面起着至关重要的作用。在这篇综述中，我们重点介绍毛细支气管炎的管理和预防的最新建议，特别关注最新文献，以寻找尚未解决的问题的答案。
