UPDATE-2022 Italian guidelines on the management of bronchiolitis in infants

被引：72

作者：

Manti, Sara ^{[1
]}

Staiano, Annamaria ^{[2
]}

Orfeo, Luigi ^{[3
]}

Midulla, Fabio ^{[4
]}

Marseglia, Gian Luigi ^{[5
]}

Ghizzi, Chiara ^{[6
]}

Zampogna, Stefania ^{[7
]}

Carnielli, Virgilio Paolo ^{[8
]}

Favilli, Silvia ^{[9
]}

Ruggieri, Martino ^{[10
]}

Perri, Domenico ^{[11
]}

Di Mauro, Giuseppe ^{[12
]}

Gattinara, Guido Castelli ^{[13
]}

D'Avino, Antonio ^{[14
]}

Becherucci, Paolo ^{[15
]}

Prete, Arcangelo ^{[16
]}

Zampino, Giuseppe ^{[17
]}

Lanari, Marcello ^{[18
]}

Biban, Paolo ^{[15
,19
]}

Manzoni, Paolo ^{[20
,21
]}

Esposito, Susanna ^{[22
]}

Corsello, Giovanni ^{[23
]}

Baraldi, Eugenio ^{[24
]}

机构：

[1] Univ Messina, Messina, Italy

[2] Univ Federico II, SIP Soc Italiana Pediat, Naples, Italy

[3] Hosp San Giovanni Calib Fatebenefratelli, SIN Soc Italiana Neonatol, Rome, Italy

[4] Univ Roma La Sapienza, SIMRI Soc Italiana Malattie Resp Infantili, Rome, Italy

[5] Fdn IRCCS Policlin San Matteo, SIAIP Soc Italiana Allergol & Immunol Pediat, Pavia, Italy

[6] Fdn IRCCS CaGranda Osped Maggiore Policlin, AMIETIP Acad Med Infermierist Emergenza & Terapia, Major Hosp Polyclin, Bologna, Italy

[7] Pugliese Ciaccio Hosp, SIMEUP Soc Italiana Med Emergenza Urgenza Pediat, Catanzaro, Italy

[8] Univ Hosp Ancona Umberto IGM Lancisi G Salesi, SIMP Soc Italiana Med Perinatale, Ancona, Italy

[9] Univ Hosp Meyer, SICP Soc Italiana Cardiol Pediat, Florence, Italy

[10] Univ Catania, SINP Soc Italiana Neurol Pediat, Catania, Italy

[11] San Giuseppe Moscati Hosp, SIPO Soc Italiana Pediat Osped, Aversa, Italy

[12] Local Hlth Author Caserta, SIPPS Soc Italiana Pediat Prevent & Sociale, Caserta, Italy

[13] Bambino Gesu Pediat Hosp, SITIP Soc Italiana Infettivol Pediat, Rome, Italy

[14] Local Hlth Author Naples 1 Ctr, FIMP Federaz Italiana Med Pediat, Naples, Italy

[15] Florence City Council, SICuPP Soc Italiana Cure Primarie Pediat, Florence, Italy

[16] IRCCS Univ Hosp Bologna, AIEOP Soc Italiana Ematol & Oncol Pediat, Bologna, Italy

[17] Univ Hosp Agostino Gemelli, SIMGePeD Soc Italiana Malattie Genet Pediat & Disa, Rome, Italy

[18] Alma Mater Studiorum Univ Bologna, Bologna, Italy

[19] Univ Hosp Verona, Verona, Italy

[20] Osped Inferm Biella, Biella, Italy

[21] Univ Turin, Turin, Italy

[22] Univ Parma, Parma, Italy

[23] Univ Palermo, Palermo, Italy

[24] Univ Hosp Padova, Dept Womens & Childrens Hlth, Neonatal Intens Care Unit, Padua, Italy

来源：

ITALIAN JOURNAL OF PEDIATRICS | 2023年 / 49卷 / 01期

关键词：

Bronchiolitis; Guidelines; Infants; Respiratory syncytial virus; Update; Prevention; RESPIRATORY SYNCYTIAL VIRUS; NEBULIZED HYPERTONIC SALINE; NASAL CANNULA OXYGEN; ACUTE VIRAL BRONCHIOLITIS; EMERGENCY-DEPARTMENT; RANDOMIZED-TRIAL; PULSE OXIMETRY; YOUNG-CHILDREN; PREVENTION; INFECTION;

D O I：

10.1186/s13052-022-01392-6

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Bronchiolitis is an acute respiratory illness that is the leading cause of hospitalization in young children. This document aims to update the consensus document published in 2014 to provide guidance on the current best practices for managing bronchiolitis in infants. The document addresses care in both hospitals and primary care. The diagnosis of bronchiolitis is based on the clinical history and physical examination. The mainstays of management are largely supportive, consisting of fluid management and respiratory support. Evidence suggests no benefit with the use of salbutamol, glucocorticosteroids and antibiotics with potential risk of harm. Because of the lack of effective treatment, the reduction of morbidity must rely on preventive measures. De-implementation of non-evidence-based interventions is a major goal, and educational interventions for clinicians should be carried out to promote high-value care of infants with bronchiolitis. Well-prepared implementation strategies to standardize care and improve the quality of care are needed to promote adherence to guidelines and discourage non-evidence-based attitudes. In parallel, parents' education will help reduce patient pressure and contribute to inappropriate prescriptions. Infants with pre-existing risk factors (i.e., prematurity, bronchopulmonary dysplasia, congenital heart diseases, immunodeficiency, neuromuscular diseases, cystic fibrosis, Down syndrome) present a significant risk of severe bronchiolitis and should be carefully assessed. This revised document, based on international and national scientific evidence, reinforces the current recommendations and integrates the recent advances for optimal care and prevention of acute bronchiolitis.

引用

页数：18

共 131 条

[61] Nebulised hypertonic saline in moderate-to-severe bronchiolitis: a randomised clinical trial [J].