Bronchiolitis

Question 1

Bronchiolitis

Answer 1

• Acute viral infection of lower respiratory tract
• Leading cause of hospital admissions < 1 years old
• Main cause is Respiratory synctial virus (RSV)

Question 2

Pathophysiology of bronchiolitis

Answer 2

• inflammation of bronchioles
• increased mucous production
• –> reduced airflow

Question 3

Clinical features of bronchiolitis

Answer 3

Symptoms:
- Coryza
- Mild fever
- Cough (dry)
- SOB
- reduced feeding
- irritable

Signs:
- tachypnoea
- fine inspiratory crackles
- wheeze
- increased work of breathing

Question 4

Investigating bronchiolitis

Answer 4

Immunofluorescence of nasal secretions

Question 5

Criteria for immediate hopsital admission in children presenting with bronchiolitis

Answer 5

• apnoea (observed or reported)
• severe respiratory distress (grunting, recessions)
• RR > 70
• central cyanosis
• O2 < 92%
• oral intake < 50% normal

Question 6

Managing bronchiolitis

Answer 6

Conservative management:
- ventilatory support
- hydration
- NG feeding
- nasal suction

Question 7

Ventilatory support algorithm in bronchiolitis

Answer 7

1. O2 mask or nasal cannulae
2. High flow humidified O2
3. CPAP
4. Intubation and ventilation