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[急性病毒性细支气管炎管理的最新进展:大西部大学医院的拟议指南]

[Update on the management of acute viral bronchiolitis: proposed guidelines of Grand Ouest University Hospitals].

作者信息

Verstraete M, Cros P, Gouin M, Oillic H, Bihouée T, Denoual H, Barzic A, Duigou A-L, Vrignaud B, Levieux K, Vabres N, Fleurence E, Darviot E, Cardona J, Guitteny M-A, Marot Y, Picherot G, Gras-Le Guen C

机构信息

Service de pédiatrie générale, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.

Service de pédiatrie générale, hôpital Morvan, CHU de Brest, 5, avenue Foch, 29609 Brest, France.

出版信息

Arch Pediatr. 2014 Jan;21(1):53-62. doi: 10.1016/j.arcped.2013.10.020. Epub 2013 Dec 8.

Abstract

BACKGROUND AND OBJECTIVES

While our European and North American colleagues have recently updated their recommendations, the 2000 Consensus Conference remains the main guideline on management of acute viral bronchiolitis in France. We aimed to establish an updated inter-regional protocol on management of acute viral bronchiolitis in infants.

METHOD

Pediatricians, pediatric pulmonologists, and emergency physicians of the Grand Ouest University Hospitals (France) gathered to analyze the recent data from the literature.

RESULTS

Criteria to distinguish childhood asthma from acute viral bronchiolitis were established, then prescriptions of diagnostic tests, antibiotics, and chest physiotherapy were defined and reserved for very limited situations. Similarly, the modalities of oxygen therapy prescription and nutritional support were proposed. Finally, other therapeutics such as nebulized hypertonic saline seem promising, but their place in the treatment of acute bronchiolitis in infants remains unclear.

CONCLUSION

This work has provided new proposals for management of acute viral bronchiolitis and helped standardize practices within the Grand Ouest University Hospitals. This local organization could lay the keystone for working toward guidelines initiated by learned societies at the national level.

摘要

背景与目的

尽管我们的欧洲和北美同行最近更新了他们的建议,但2000年共识会议仍然是法国急性病毒性细支气管炎管理的主要指南。我们旨在制定一项关于婴儿急性病毒性细支气管炎管理的更新的区域间方案。

方法

法国大西部大学医院的儿科医生、儿科肺科医生和急诊科医生聚集在一起分析最近的文献数据。

结果

确立了区分儿童哮喘与急性病毒性细支气管炎的标准,然后确定了诊断测试、抗生素和胸部物理治疗的处方,并将其保留在非常有限的情况下。同样,提出了氧疗处方和营养支持的方式。最后,其他治疗方法如雾化高渗盐水似乎很有前景,但它们在婴儿急性细支气管炎治疗中的地位仍不明确。

结论

这项工作为急性病毒性细支气管炎的管理提供了新的建议,并有助于大西部大学医院内的实践标准化。这种地方组织可为朝着国家层面学术团体发起的指南努力奠定基石。

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