Treatment Of Acute Bronchiolitis Research Articles

Effect of azithromycin administration in cases of acute bronchiolitis – A systematic review and meta-analysis

Acute Bronchiolitis is the most common viral lower respiratory tract infection in infants requiring hospitalization. Management is usually symptomatic and supportive with no specific treatment options. Although viral, Azithromycin by its anti-inflammatory properties might play a role in improving the clinical outcome. The objective was to assess the effect of azithromycin on length of hospital stay and duration of oxygen requirement in cases of acute bronchiolitis. Data sources such as PubMed and Google Scholar were systematically searched till June 2023. The meta-analysis included all published, randomized controlled trials that investigated the efficacy of Azithromycin over placebo in infants <24 months with acute bronchiolitis. Data extraction was guided by a predetermined checklist. Using RevMan 5 software, the mean length of hospital stay and duration of oxygen administration were pooled from the selected studies. The fixed-effect model was used to compare the length of hospital stay and the duration of oxygen administration in the Azithromycin and placebo group. Data analyses were performed in July 2023. The primary outcome was a comparison of the length of hospital stay in infants with Bronchiolitis receiving either azithromycin (intervention) or placebo (control). The secondary outcome was the assessment of the duration of oxygen requirement in both intervention and control groups.The initial search yielded 601 records of which 68 articles underwent full-text evaluation, which identified four articles and a total of 571 patients that were included. The findings did not favor the usage of azithromycin antibiotic in treatment of acute bronchiolitis (Mean deviation = 1.21, 95% CI 0.53–2.78, P = 0.80). An insignificant Q statistic (P = 0.001) indicated the absence of heterogeneity (I2 = 0%). Length of hospital stay showed an overall insignificant effect as the length of stay is almost similar in both drugs (OR = 1.04 95% CI 0.49–2.23, P = 1.00). An insignificant Q statistic (P = 1.00) indicated the absence of heterogeneity (I2 = 0%).

Overview of the etiology, risk factors, clinic, diagnostics and treatment of acute bronchiolitis

Overview of the etiology, risk factors, clinic, diagnostics and treatment of acute bronchiolitis

Efficacy of nebulized hypertonic saline versus normal saline in the treatment of acute bronchiolitis in inpatient infants.

Aim Compare the efficacy of nebulized hypertonic saline and normal saline in the treatment of infants hospitalized for bronchiolitis. Methods This retrospective study was conducted at the Department of Pulmonology, Paediatric Clinic, Clinical Centre University of Sarajevo, covering the period from January 2015 to December 2019 and comprising 380 children aged between 1 and 12 months having bronchiolitis. One group received nebulized hypertonic saline (NHS, 3% NaCl)), and another group received nebulized normal saline (NNS, 0.9% NaCl). The control group did not receive any of these treatment options. Results There was no statistically significant difference between the treatment groups regarding length of hospital stay (LOS) and Clinical Severity Score (CSS) at admission and discharge as well as in oxygen therapy duration and antibiotic use, the duration of symptoms before hospital admission, frequency of nasal discharge, elevated temperature, dyspnoea, cough and dehydration. Conclusion The results of this study are consistent with several recent studies or meta-analyses and support the evidence against the use of NHS in hospitalized infants with mild or moderate bronchiolitis.

Comparison of Hypertonic Saline vs Salbutamol in Normal Saline Nebulization in Children with Bronchiolitis

Background: Main stay of treatment of acute Bronchiolitis is general supportive care, such as oxygenation, aspiration of respiratory tract secretions, and hydration therapy. Recent research indicates that breathed hypertonic saline is a potential treatment. Objective: To compare the mean length of hospital stay and clinical bronchiolitis score of salbutamol nebulized in normal saline versus hypertonic saline in children with acute bronchiolitis. Material and methods Study Design: Randomized controlled design Setting: Department of pediatrics, Fatima Memorial Hospital, Lahore. Duration of Study: 6 months after approval of the study i.e. from 12th April 2017 to 12th October 2017. Data Collection Procedure: Relevant parameters were identified, and the CBSS was computed. Using random tables, cases were divided among two groups and given salbutamol or hypertonic saline nebs. The length of stay was determined. The Clinical Bronchiolitis Severity Score (CBSS) was recorded based on various variables. Version 17 of the statistical package for social sciences was used for statistical analysis. Result: Patients in the salbutamol group had a mean age of 13.56.66 months, while those in the hypertonic saline group had a mean age of 12.46.58 months. In the group receiving salbutamol, there were 29 males and 31 females. There were 32 men and 28 women in the hypertonic saline group. After 24 hours, the mean CBSS in the salbutamol group was 6.132.47, whereas in the hypertonic saline group, it was 4.881.75. After 24 hours of treatment, the difference in CBSS was significant between the two groups (P0.05). The mean duration of hospitalization was 3.920.81 days with salbutamol and 3.050.77 days with the hypertonic group. In both groups, there was a marked difference in duration of hospital stay (P0.05). Conclusion: Thus, hypertonic saline was more effective than salbutamol in reducing the CBSS score and duration of hospital stay. Keywords: Hospital Stay, Clinical Bronchiolitis Score, Nebulized Salbutamol, Normal Saline, Hypertonic Saline, Children, Acute Bronchiolitis.

Inhaled Nitric Oxide for the Treatment of Acute Bronchiolitis: A Multicenter Randomized Controlled Clinical Trial to Evaluate Dose Response.

Rationale: Inhaled nitric oxide (iNO) has potential antiinflammatory, antimicrobial, and antiviral properties for patients with lower respiratory tract infections. Objectives: We compared the safety and efficacy of iNO administered in two concentrations in addition to standard supportive treatment (SST) compared with SST alone with the aim of improving clinical outcomes of infants with bronchiolitis. Methods: In this prospective, multicenter, double-blind, randomized controlled study, 89 infants hospitalized with moderate to severe bronchiolitis were randomly assigned to three treatment groups: 150 ppm NO plus SST (group 1), 85 ppm NO plus SST (group 2), and the control treatment (O2/air plus SST) (group 3). Treatment was given for 40 minutes, four times each day, for up to 5 days. The primary endpoint was time to reach "fit for discharge." This was a composite endpoint composed of both reaching a sustained oxygen saturation ≥92% on room air and reaching a clinical score ⩽5. Secondary endpoints included time to reach sustained oxygen saturation ≥92% on room air, time to clinical score ⩽5, and time to hospital discharge. Safety was assessed by the number of treatment-related adverse events (AEs) or serious AEs. Time-to-event efficacy outcomes were analyzed using a Cox proportional hazards regression model. Hazard ratios (HR) describe how many times more likely an individual is to experience an event, if such an individual receives NO rather than the control treatment during the observational period. Results: Group 1 demonstrated significant efficacy for time to reach fit to discharge compared with groups 2 (HR, 2.11; P = 0.041) and 3 (HR, 2.32; P = 0.049). Group 1 also demonstrated significant efficacy for time to hospital discharge compared with groups 2 (HR, 2.01; P = 0.046) and 3 (HR, 2.28; P = 0.043). No significant differences were observed between groups 2 and 3 for either endpoint. There were no differences between treatment groups in time to reach a clinical score ⩽5. The iNO therapy was well tolerated, with no treatment-related serious AEs. Conclusions: Treatment with high-dose intermittent iNO at 150 ppm showed reduced time to clinical improvement compared with 85 ppm or control treatment of hospitalized infants with acute bronchiolitis. The 150-ppm iNO dose is well tolerated, with significant benefit compared with both standard therapy and 85 ppm iNO, improving respiratory outcomes and reducing length of stay. Clinical trial registered with www.clinicaltrials.gov (NCT04060979).

A randomized clinical trial to assess the effect of zinc and vitamin D supplementation in addition to hypertonic saline on treatment of acute bronchiolitis

BackgroundBronchiolitis, the most common cause of hospitalization in infancy has not yet a definitive treatment. This study was conducted to assess the effect of Zinc and vitamin D on treatment of infants with bronchiolitis.MethodsIn this double blind, randomized clinical trial, 94 infants aged 2 to 23 months, admitted in Mousavi Hospital in Zanjan, Iran, with the diagnosis of acute bronchiolitis were randomly assigned into 3 groups. The control group was only treated with hypertonic saline. The two case groups received either 100 unit/kg/day of Vitamin D or 20 mg/day of zinc in addition to hypertonic saline. Wheezing, duration of hospital stay, cough, cyanosis, respiratory distress and the respiratory rate in the first, third and seventh day of hospitalization were evaluated.ResultsThere was no significant difference between groups in terms of age, sex, weight, passive smoking, wheezing, oxygen saturation, cyanosis and type of delivery. On the third day of hospitalization, the respiratory rate/min in the control group, the groups receiving vitamin D and zinc were 45.2 ± 10.7, 37.8 ± 3.9 and 41.1 ± 9.1 respectively and the result of repeated measure analysis didn’t show any significant difference between the 3 groups (P = 0.562). Duration of hospitalization in the group receiving Vitamin D or zinc and in controls were 4.2 ± 2.6, 4.4 ± 2.2 and 5.1 ± 2.4 days respectively and this difference was not significant. Zinc receiving patients did not differ from the control group regarding to respiratory rate, cyanosis and wheezing.ConclusionVitamin D or zinc administration was not effective in reducing respiratory rate in children with bronchiolitis.Trial registration This project was approved by the Institutional Ethics Committee (IR, ZUMS.REC.1396.50), and registered on IRCT (IRCT20131217015835N7).

Evaluation of Efficacy of Oral Prednisolone in the Treatment of Acute Bronchiolitis in a Tertiary Level Hospital in Rajshahi

Bronchiolitis is a viral infection of lower respiratory tract that occurs most commonly in young children (< 2years). It is one of the most common cause of hospitalization of infants. It has a major public health hazard throughout the world exerting significant morbidity and mortality. Methods: This randomized controlled trial study was conducted in the Department of pediatrics, Rajshahi Medical College Hospital. Total 120 patients with acute bronchiolitis were selected who were less than two years of age. Two groups were randomly selected by lottery method. One group was given salbutamol along with prednisolone (Experimental group) another was only salbutamol (Placebo group) to compare the efficacy and evaluate the outcome of both treatment groups. Result: The mean age of the experimental group was7.09±4.71 months and mean age of placebo group was 5.70±4.26 months. The majority number of patients 96(80%) came from middle class family with 30(25%) houses with crowded conditions. About 16(13.3%) patients were born in preterm condition and 18(15%) were low birth weight. Among the family members 21(17.5%) had asthma and 43(35.18%) had smoking history. After treatment notable outcome clinically observed after 3 days of treatment in experimental than placebo group (p-value <0.05). Oral prednisolone reduces 1-2 days of hospital stay (p- value <0.001) compared to placebo group. The use of prednisolone reduces the severity of disease more rapidly in association with placebo group (p - value <0.001). Conclusions: Bronchiolitis is one of the most common disease in the young children and is the frequent reason for hospitalization. Prednisolone is useful in the reducing hospital stay and improving respiratory symptoms. TAJ 2021; 34: No-2: 95-101

Bronchiolitis diagnosis, treatment, and prevention in children: an evidence-based clinical practice guideline adapted for the use in Egypt based on the \u2018Adapted ADAPTE\u2019 Methodology

BackgroundThe presented evidence-based clinical practice guideline (CPG) is proposed as a National CPG using an evidence-based and formal CPG adaptation methodology. The purpose of this study was to adapt the international CPGs’ recommendations for children with bronchiolitis to suit the healthcare system in the Egyptian context. This CPG, ‘diagnosis, treatment, and prevention of Bronchiolitis’, applies to children from 1 through 23 months of age. Other exclusions are noted. The quality of evidence, benefit-harm relationship, and strength of recommendations are indicated. This study is part of a larger collaborative initiative with the faculty staff of pediatric departments of 15 Egyptian universities and a national research center to formulate a national Committee (EPG) that aims to define the topics of, assign authors to, and assist in the adaptation of pediatric evidence-based CPGs according to a national strategic plan. The committee is guided by a formal CPG adaptation methodology: the ‘Adapted ADAPTE’.ResultsThe Bronchiolitis Guideline Adaptation Group (BGAG) reviewed the results of the AGREE II assessment and decided to adapt mainly the Australasian (PREDICT) CPG and for the questions not answered in PREDICT we adapted the relevant recommendations from the American Academy of Pediatrics (AAP) CPG. Seven implementation tools were included: a care pathway for assessment of severity, a clinical algorithm for treatment of acute bronchiolitis in the emergency room, a separate flowchart for assessing babies with bronchiolitis, a power point slide presentation lecture for treatment of acute bronchiolitis, patient information in Arabic, a clinical score (Modified Tal Score) for prediction of bronchiolitis severity, and the criteria for admission and discharge in the hospital. A comprehensive set of multifaceted CPG implementation strategies was provided for the clinicians, patients, nurses, and other relevant stakeholders contextualized to the national settingsConclusionOur experience with this adaptation methodology provides useful insight into its utilization on a national level in Egypt. The BGAG recommended the next review of this adapted CPG to be after 3 years from its publication (i.e., 2022) after checking for updates in the original CPG.

A modern view on the treatment of acute bronchiolitis in pediatric intensive care units: a review

INTRODUCTION. The literature has accumulated enough data on the treatment of children with acute bronchiolitis (OB). However, this information is formed mainly on the general population of patients with OB and is often not applicable to patients with a severe course of the disease. From the standpoint of evidence-based medicine, routine use of medications is not recommended in modern consent documents, and there are also no clear recommendations on respiratory support and certain aspects of intensive care in children with OB. OBJECTIVES. To analyze approaches to therapy in children with severe acute course in need of intensive care, and to assess the validity, effectiveness and safety of the use of the analyzed groups of drugs and respiratory strategies. MATERIALS AND METHODS. The analysis of publications in the electronic databases PubMed and the Russian Scientific Citation Index on the keywords “bronchiolitis”, “intensive care units”, “critical care”, “fluid therapy”, “respiratory therapy”, “ventilation”, “co-morbidity”; “respiratory syncytial virus”; “hypertonic saline” was carried out, “corticosteroids”; “epinephrine”; “high-flow oxygen therapy”, “inhalation”, “infant”, “bronchiolitis in children”. The date of the last search is January 15, 2022. RESULTS. This systematic review provides information on the etiology and risk factors of severe acute respiratory syndrome in children, from the standpoint of evidence-based medicine, studies on the treatment of severe acute respiratory syndrome are characterized, including in the intensive care unit with glucocorticosteroids, inhalations of bronchodilators, epinephrine, 3 % hypertonic sodium chloride solution, respiratory support, high-flow oxygenation, noninvasive ventilation, artificial ventilation, antibiotics, air-helium mixture. CONCLUSIONS. Currently, there is more information that infants with OB show a high degree of heterogeneity, while the main uncertainty lies in a misunderstanding of the processes, which patients will benefit most from a particular treatment method. Further research is needed to fill the research deficit in children with a severe course of OB.

Role of Nebulized Magnesium Sulfate Versus Nebulized Budesonide In treatment of Acute Bronchiolitis and Its Outcome

Role of Nebulized Magnesium Sulfate Versus Nebulized Budesonide In treatment of Acute Bronchiolitis and Its Outcome

Budget Impact Analysis of Hypertonic Saline Inhalations for Infant Bronchiolitis: The Colombian National Health System Perspective

ObjectivesNebulized 3% hypertonic solution (HS) is associated with lower total cost and higher quality-adjusted life-years. Nevertheless, the expected budget impact of this drug had not been explicitly estimated. The aim of this study was to evaluate the budget impact of 3% HS in the treatment of acute bronchiolitis in Colombia. MethodsA budget impact analysis was performed to evaluate the potential financial impact of the use of 3% HS. The analysis considered a 4-year time horizon and a Colombian national health system perspective. The incremental budget impact was calculated by subtracting the cost of the new treatment, in which 3 % HS (added to humidified oxygen) was reimbursed, from the cost of the conventional treatment without 3 % HS (only humidified oxygen or adrenaline nebulization). Univariate 1-way sensitivity analyses were performed. ResultsIn the base-case analysis, the 4-year costs associated with HS and non-3% HS were estimated to be $47 792 230 and $53 312 832, respectively, indicating savings for Colombian national health system equal to $5 520 602 if HS is adopted for the routine management of patients with acute bronchiolitis. This result was robust in univariate 1-way sensitivity analysis. ConclusionHS was cost saving in emergency settings for treating infants with acute bronchiolitis. This evidence can be used by decision makers in Colombia to improve clinical practice guidelines and should be replicated to validate their results in other middle-income countries.

A randomized controlled trial of nebulized epinephrine versus nebulized hypertonic saline in infants with acute bronchiolitis

Background: Acute Bronchiolitis is an infection of the lower respiratory tract, most frequently caused by the respiratory syncytial virus. It is one of the most common cause of hospital admission for respiratory tract illnesses in infants. This is a double blinded randomized controlled trial, conducted to compare the therapeutic efficacy of nebulized epinephrine versus nebulized hypertonic saline in infants with acute bronchiolitis.Methods: It was a double blinded randomized controlled trial conducted over a period of 18 months (January 2019-June 2020) in infants aged 2 months to 1 year diagnosed with acute bronchiolitis. All eligible patients were randomly assigned to one of two groups: Group I received inhalation of Epinephrine; Group II received inhalation of Hypertonic (3%) Saline. Patients in each group received four treatments on each day of hospitalization, delivered at 6 hourly intervals. Monitoring parameters for improvement or worsening of the condition were measured and recorded on admission and then at 24 hourly intervals using the clinical score described by Wang, et al for the first three days of treatment.Results: Among the infants treated with hypertonic saline, there was a significant decrease in the post inhalation respiratory score on day 2 and day 3 as compared to the infants treated with epinephrine. There was a significant difference in duration of hospitalization between the two groups as duration of hospitalization in infants was less in hypertonic saline group as compared to the epinephrine group. Hypertonic saline also showed significantly lesser side effects post inhalation when compared to epinephrine. The difference was statistically significant with p<0.0001.Conclusions: The study concluded that the use of nebulized hypertonic saline in infants aged 2 months to 12 months, provides evidence for its role as an efficient treatment modality in the treatment of acute bronchiolitis. The study also found that nebulized epinephrine had more side effects associated with it.

High-flow oxygen nasal cannula for treating acute bronchiolitis in infants: A systematic review and meta-analysis.

Oxygen therapy through a high-flow nasal cannula is thought to improve the work of breathing and the comfort of patients with acute bronchiolitis. It is widely used in hospital wards and critical care of pediatric patients. However, there is uncertainty on the magnitude of the effect on critical and important outcomes in these patients. The objective of this review is to evaluate the available evidence on the use of oxygen administered through high-flow cannula versus low-flow oxygen for the treatment of acute bronchiolitis in children under two years of age. We carried out a systematic review and a meta-analysis following the PRISMA standards for reporting. The search was carried out in electronic databases by two researchers independently. The evidence was summarized using the GRADE methodology. Six randomized and non-randomized clinical trials were included, including 1867 individuals younger than 24 months of age with acute bronchiolitis in pediatric emergency, hospitalization, and intensive care services. Mortality was not reported in the included studies. Treatment failure occurred in 108/933 in the high flow group and 233/934 in the low flow group (relative risk: 0.46; 95% confidence interval: 0.35 to 0.62), which shows 11.7% less treatment failure (95% confidence interval between 7.9% and 14.5% less) in the high flow group with a number needed to treat of 7.5 (95% confidence interval 6 to 10) with moderate certainty in the evidence. The use of humidified and heated oxygen with high flow compared to oxygen at low flow is probably associated with decreased treatment failure in children younger than two years with acute bronchiolitis. There is uncertainty about the effect on hospitalization days and clinical progression.

Treatment for acute bronchiolitis before and after implementation of new national guidelines: a retrospective observational study from primary and secondary care in Oslo, Norway

BackgroundAcute bronchiolitis treatment guidelines changed in Norway in 2013, no longer recommending the use of nebulised epinephrine. We aimed to assess whether these changes were successfully implemented in both primary...

Treatment of Acute Bronchiolitis in a Resource-limited Setting in Port Sudan City: A simple Effective Regimen

Background: Bronchiolitis is an acute lower respiratory viral infection, caused by the Respiratory Syncytial Virus (RSV) in 60–85% of cases and other respiratory viruses in remaining ones. It is the leading cause of hospitalization for infants and toddlers during the winter and early spring months. At the moment, there is no consensus on its treatment worldwide. The prevalence is increasing in port Sudan eastern Sudan, while we have no admission policy or a unified management protocol. Therefore, the aim of this study is: (1) to formulate an admission policy and a new simple management protocol; (2) to determine the factor(s) that increased the prevalence in port Sudan as a secondary objective; and (3) to compare the outcome in the study (119 infants) and historical (135 infants) groups concerning the hospitalization length and death rate as a primary objectives.
 Method: This is a hospital-based, controlled clinical trial (CCT) study, demographic data were collected by a questionnaire, and data were analyzed manually. Severity criteria for acute bronchiolitis are defined. A management guideline was defined and applied to bronchiolitis cases (119 case) with intention to treat, from October to April each year (2013–2015). All infants aged between 1 and 23 months with only acute bronchiolitis were included, while cases with bronchiolitis and associated dysmorphic features, heart disease, tracheo-oesophageal fistula, other respiratory diseases, other morbidities, infants below one month or above two years were excluded from this study. The outcome was compared to a group of matched infants with bronchiolitis (135 cases) who received antibiotics, B2 agonist, and steroids, between October and April of years 2011–2012.
 Results: While several new lifestyle factors increased the prevalence, the new guidelines decreased the admission rate (9.6 vs 5.7 mo), is simple and effective, less expensive, and the duration of hospitalization also reduced (p = 0.04).
 Key words:
 acute bronchiolitis, resource-limited settings, advanced respiratory intervention, simple effective intervention,S-7Pro3NO regimen

Acute Bronchiolitis Treatment: A Comparison of Montelukast, Aminophylline and Ventolin in pediatric group

Background: The effects of various drugs on reducing the severity of bronchiolitis symptoms in children have been identified. We sought to make a comparison of Montelukast, Aminophylline and Ventolin (Intravenous Salbutamol) in the treatment of acute bronchiolitis in pediatric group . Methods:This study used a randomized clinical trial method. Statistical population of the study included all patients who were admitted to Ali-Ibn-Abitaleb Hospital in Zahedan-Iran in children younger than 2 years and older than one month. 200 patients were divided into four groups using a random number table method. The first group received supplemental monotherapy with Montelukast 4 mg/kg daily for 7 days. The second group received 1 mg/kg Aminophylline injection every 12 hours. The third group or the control group received supportive measures. The fourth group received 0.15 mg/kg Ventolin nebulizer with dose of 2.5 mg. Symptoms were measured on days 2, 5 and 7, and the number of hospital admissions days was also assessed in four group and compared. Results: The results showed that the consumption of Montelukast and Ventolin had no significant effect on bronchiolitis treatment in comparison with the control group (P>0.05). Using Aminophylline did not reduce the symptoms of bronchiolitis in comparison with the control group (p <0.05). The results also showed that using aminophylline in group B did not produce better results in decreasing the severity of the symptoms of bronchiolitis in comparison with the groups A and D (p <0.05). Conclusion: The results showed that consumption of Aminophylline, Montelukast and Ventolin had no significant effect on bronchiolitis in comparison with the control group. Finally, a study with more patients and different doses in the future is suggested.

Electromagnetic inductance plethysmography to study airflow after nebulized saline in bronchiolitis

Spirometric effects from therapeutic interventions in infants with severe respiratory distress cannot readily be measured, hampering development of better treatment for acute bronchiolitis. Inhaled normal saline is regularly used in these infants, with little knowledge of how this influences lung physiology. Assess feasibility of infant lung function testing using electromagnetic inductance plethysmography (EIP) in a clinical setting in a busy pediatric department, and explore effects from inhaled normal saline on tidal flow-volume loops in infants with acute bronchiolitis. Observational study conducted at the Children's Clinic, Haukeland University Hospital, Bergen, Norway during the winters 2016 and 2017, enrolling children with bronchiolitis below six months of age. EIP was performed immediately before and 5 and 20 min after saline inhalation. EIP is a noninvasive method to measure tidal breathing parameters by quantifying volume changes in the chest and abdomen during respiration. The method consists of an electromagnet/antenna and a patient vest. EIP was successfully applied in 36/45 (80%) enrolled infants at mean (standard deviation) age 2.9 (2.5) months, after a hospital stay of 2.2 (1.9) days. After saline inhalation, tidal expiratory to inspiratory time ratio (Te/Ti) had increased significantly, whereas the other relevant flow/volume parameters had changed numerically in a direction compatible with a more obstructive pattern. EIP could successfully be used to obtain tidal breathing parameters in infants with respiratory distress and appears a promising tool for assessment of therapeutic interventions in bronchiolitis. Saline inhalations should be used with caution as placebo in intervention studies.

Designing and manufacturing of a user friendly and affordable nasal suction machine for Acute Bronchiolitis treatment of children in Oman

Acute Bronchiolitis is a disease which usually infects children of the age 0 to 6 years old. The patients infected by this disease require medical attention at hospitals. The patients must be admitted in the hospitals for a period of 2-3 days. Parents of the patients must stay in the hospital along with them. This causes lack of hospital beds, more expense of the hospital to provide extra food for the parents. By a qualitative research, it was found that parents would want an affordable device so that they could care for their children from home instead of staying at the hospital. Parents from all over Oman come to the capital so that their children can be treated. Children also tend to get exposed to more sickness by being around sick children at the hospital. Taking this problem into consideration, a circuit has been designed in such a way it was easy to use and that it could be used by parents to treat their children at home without the need to visit a hospital. The circuit works on Arduino Uno and has various pre-existing modules attached to it , the estimated cost of the device is far lesser than what the mainstream industrial devices cost. The device consists of a Bluetooth Module for the purpose of connectivity via cellphone ,a 12V vacuum pump to suck the mucus out of the patient’s lungs, variable resistor to control the force of vacuum and a rubber tube capable of fitting into the nostril to allow suction of mucus. This simple device made from the counter parts can offer significant benefits to patients affected by Acute Bronchitis.

Pediatricians' Attitude in Management of Acute Bronchiolitis: Did Guidelines Overcome Practices?

Background: Acute bronchiolitis is one of the most common diseases of early childhood. There are many recent changes in the treatment of acute bronchiolitis. The aim of this study is to evaluate treatment approaches to acute bronchiolitis among clinicians and to observe compliance with clinical guidelines. Materials and Methods: Our study was designed as a multicenter cross-sectional descriptive study. A cohort of pediatric residents, fellows, and attendants were surveyed with a questionnaire including general and occupational characteristics of pediatricians and treatment choices in acute bronchiolitis. Results: A total of 713 questionnaires were collected. Most commonly applied treatment among pediatricians was inhaled salbutamol, followed by intravenous hydration, hypertonic saline, and inhaled steroid. Most commonly preferred treatment in the management of mild bronchiolitis was oral hydration and inhaled salbutamol in severe bronchiolitis. Conclusion: Although recent guidelines for the treatment of acute bronchiolitis does not support the use of many different therapies, pediatricians still tend to use them, especially bronchodilators, corticosteroids, and antibiotics.

Comparative evaluation of nebulised 3% saline versus nebulised 0.9% saline in the treatment of acute bronchiolitis

Background: Acute bronchiolitis is the most common respiratory tract infection in young children. Despite the high prevalence of acute bronchiolitis, no consensus exists on the management. Studies have shown that except oxygen therapy, no other treatment found to be effective. Hence, the present study was conducted to find out the efficacy of nebulised 3% saline versus is 0.9% saline for the treatment of acute bronchiolitis.Methods: A prospective randomized controlled study of 150 children between the age group of 2 months to 24 months with signs and symptoms of Acute Bronchiolitis admitted to Indira Gandhi Institute of Child Health, Bangalore from January 2016 to December 2016 formed the study group, they were randomized into 2 groups, one received 3% saline nebulization and the other received 0.9% saline.Results: A total of 150 children were enrolled in the study, 75 children (group A) received 0.9% saline and 75 children (group B) received 3% saline. At 24 hours, the mean clinical severity score for group A was 2.49±1.03 and group B was 2.16±0.49 (P=0.013). The duration of hospital stay was shorter (1-3 days) in 3% saline with a mean of 2.35 days and was longer (3-5 days) in 0.9% saline with mean value of 4.04 days which was statistically significant (p &lt;0.001).Conclusions: 3% saline nebulization can be used as an effective treatment for acute bronchiolitis. It significantly reduced the clinical severity score and length of hospital stay compared to 0.9% normal saline.