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急性细支气管炎:急诊科的评估与管理

Acute bronchiolitis: assessment and management in the emergency department.

作者信息

Joseph Madeline M, Edwards Amy

机构信息

Professor of Emergency Medicine and Pediatrics; Assistant Chair of Pediatric Emergency Medicine Quality Improvement, Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL.

University of Florida at Jacksonville Pediatrics, Jacksonville, FL.

出版信息

Pediatr Emerg Med Pract. 2019 Oct;16(10):1-24. Epub 2019 Oct 2.

Abstract

Acute bronchiolitis is the most common lower respiratory tract infection in young children that leads to emergency department visits and hospitalizations. Bronchiolitis is a clinical diagnosis, and diagnostic laboratory and radiographic tests play a limited role in most cases. While studies have demonstrated a lack of efficacy for bronchodilators and corticosteroids, more recent studies suggest a potential role for combination therapies and high-flow nasal cannula therapy. Frequent evaluation of patient clinical status including respiratory rate, work of breathing, oxygen saturation, and the ability to take oral fluids are important in determining safe disposition. This issue reviews the literature to provide evidence-based recommendations for effective evaluation and treatment of pediatric patients with acute bronchiolitis.

摘要

急性细支气管炎是幼儿中最常见的下呼吸道感染,可导致患儿前往急诊科就诊及住院。细支气管炎是一种临床诊断,在大多数情况下,诊断性实验室检查和影像学检查作用有限。虽然研究表明支气管扩张剂和皮质类固醇缺乏疗效,但最近的研究提示联合治疗和高流量鼻导管治疗可能具有一定作用。频繁评估患者的临床状况,包括呼吸频率、呼吸功、血氧饱和度以及口服液体的能力,对于确定安全的处置方式很重要。本期专题回顾文献,为有效评估和治疗急性细支气管炎患儿提供循证推荐。

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