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Bronchiolitis (Risk factors (Gestational age <37 weeks, Chronological…
Bronchiolitis
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Treatment
Bronchiolitis is usually self-limiting, usually requiring no treatment or interventions. Medications do not generally help bronchiolitis symptoms, however interventions can be used to manage comfort
Hydration/nutrition
If non-oral hydration required, either nasogastric or intravenus hydration is appropriate
If IV fluids required follow Starship IV Fluids guideline
Caffeine
Sometimes used in CED and PICU for very young infants with apnoea. Caffeine should be stopped as soon as an infant is transferred to ward as it has a long half-life. This can make decisions regarding safety of discharge more difficult.
Oxygen therapy
-Oxygen therapy if saturations persistently < 92%
-Brief, self-correcting mild/moderate desaturations of < 92% do not require oxygen therapy
-Discontinue oxygen therapy when saturations persistently >92%
Airvo
The AIRVO 2 system features a humidifier with integrated flow source that delivers high flows of air/oxygen mixtures to spontaneously breathing patients, through a variety of interfaces up to 60 L/min.
Provides optimal humidity: Lung compliance and mucociliary function are rapidly compromised by gas that is not heated and humidified. Bronchoconstriction associated with airway cooling is reduced.
Decreases energy expenditure: The humidity also reduces the evaporative losses from the mucosa of the immature airway (<2 yrs), reducing the energy required for gas conditioning.
Improves alveolar ventilation: The nasal passages and oropharynx are continuously flushed and replenished, removing exhaled gas to reduce re-breathing and increase the clearance of carbon dioxide
What is it?
Bronchiolitis is an acute viral infection affecting the bronchioles of the lower respiratory tract. Most cases are caused by Respiratory Syncytial Virus (RSV).
Diagnosis
Viral bronchiolitis is a clinical diagnosis, based on typical history and examination. Peak severity is usually at around day two to three of the illness with resolution over 7-10 days. The cough may persist for weeks. Bronchiolitis most commonly occurs in the winter months, but can be seen all year round.
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