Pediatrics Bronchiolitis - Symptoms, Causes and Treatment of Pediatrics Bronchiolitis

Most cases of bronchiolitis are caused by viruses. The respiratory syncytial virus (RSV) and parainfluenza virus being the most common ones. Less frequent are influenza, adenovirus, rhinoviruses, and measles virus. Rarely, the bacteria Mycoplasma pneumoniae can be the cause of bronchiolitis. Bronchiolitis is a common illness amongst young children, mostly under 2 years with the majority under 6 months of age. Bronchiolitis should run its course in about 4-5 days, but it can persist for over a week.

Hospitalisation is usually not required in most cases, unless there is severe difficulty in breathing, or the patient showing signs of low oxygen level, dehydration or fatigue. During the early phase of the illness, close monitoring at hospital are often considered if there is other underlying health problems for example heart disease, poor immune system and underdevelopment of the lung.

Bronchiolitis typically begins with fever and coryza, and then progresses to cough and wheezing. Signs of respiratory distress occur in severe cases. Failure to maintain hydration and development of respiratory distress or failure are the classic reasons for hospital admission. Hospital care is basically supportive and includes intravenous hydration, supplemental oxygen, nasal suction, and mechanical ventilation.

Symptoms of Pediatrics Bronchiolitis

• Fever
• Increased work of breathing
• Wheezing
• Cyanosis
• Grunting
• Noisy breathing
• Vomiting, especially post-tussive
• Irritability
• Poor feeding or anorexia

Treatment for Pediatrics Bronchiolitis

• General supportive measures are the mainstay of treatment for patients with bronchiolitis.
• Patients should be made as comfortable as possible (held in a parent's arms or sitting in the position of comfort).
• Cardiorespiratory monitoring is essential.
• Pulse oximetry is a helpful tool, as hypoxia is common.
• Humidified oxygen should be administered if the oxygen saturation is less than 94% on room air.
• The ability to maintain adequate hydration should be assessed by observing patient oral intake. Many dyspneic infants have difficulty taking a bottle.

Depending upon the severity of the illness and age of the infant, a chest x-ray and blood tests may be performed. Treatment usually involves general supportive care and fever control with acetaminophen. Plenty of fluids or juice will keep the child well hydrated and make the secretions easier to accommodate.

A cool mist vaporizer (in the bedroom) can also help keep the nasal passages clear. More pronounced wheezing could warrant the use of a prescription bronchodilator medication (e.g. Alupent, Proventil) administered in the emergency room, or routinely at home

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