Glucocorticoids for acute viral bronchiolitis in infants and young children

Patel, Hema; Platt, R; Lozano, J M

doi:10.1002/14651858.cd004878.pub2

Cited by 34 publications

(7 citation statements)

References 61 publications

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“…Inhalations with beta-2 agonists are used in up to 85% of patients with positive effect on clinical score, but they do not affect the length of hospital stay 25 . But recent systematic analysis has shown that treatment with systemic glucocorticoids does not have impact on clinical score or the length of hospital stay 27 . But recent systematic analysis has shown that treatment with systemic glucocorticoids does not have impact on clinical score or the length of hospital stay 27 .…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of respiratory syncytial virus infection in neonates and young infants

Savić

Janković

Minić

et al. 2011

VSP

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Infection with RSV in our settings showed marked seasonal characteristics with highest hospitalization rate in January. Although the course and outcome of the disease were favorable in the majority of our patients, the need for hospitalization and administration of therapy with possible side effects warrants that general measures for prevention of respiratory infections are followed especially in the first year of life. Severe disease and death are more probable in neonates and infants with risk factors. In these children passive immunisation with specific monoclonal antibody (e.g. palivizumab) during RSV season should be considered.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of respiratory syncytial virus infection in neonates and young infants

Savić

Janković

Minić

et al. 2011

VSP

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“…Steroide sind weder inhalativ noch systemisch angezeigt [7], ebenso keine Schleimlöser oder Antibiotika. …”

Section: Therapieunclassified

Respiratorische Notfälle im Kindes- und Jugendalter

Riedler¹

2011

Monatsschr Kinderheilkd

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Da die pulmonalen Reserven von Kindern, v. a. im Säuglings-und Kleinkindesalter, gering sind, kann es bei ihnen schneller als bei Erwachsenen zu einer Hypoxie kommen. Der frühzei-tigen Erkennung und adäquaten Behandlung respiratorischer Notfäl-le kommt deshalb entscheidende Bedeutung zu. Hierzu sind entsprechende Kenntnisse der Symptome und geeigneter Behandlungsmaßnahmen unverzichtbar. Zusammenfassung · AbstractMonatsschr Kinderheilkd 2011 · 159:938-947

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“…Several meta analyses and Cochrane reviews have concluded that bronchodilators, epinephrine and corticoste roids have no role in the routine care of children with bronchiolitis [3][4][5][6][7]. In addition, the routine use of a chest xray (CXR) in the diagnosis of The Institute of Medicine defines quality as "The degree to which health services for indi viduals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge [101]."…”

Section: Shortfalls In the Quality Of Carementioning

confidence: 99%

Quality of Care for Common Pediatric Respiratory Infections: Shortfalls and Improvements

Mann

Knapp

2009

Pediatric Health

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Bronchiolitis Shortfalls in the quality of careBronchiolitis is the most common childhood clinical manifestation of viral lower respiratory tract infections. It is characterized pathophysio logically by acute inflammation and edema of the airway, and clinically by rhinorrhea, inspira tory crackles, expiratory wheezing and varying degrees of respiratory distress. Patients at par ticular risk for severe disease include preterm infants, those with cyanotic congenital heart disease and the immunodeficient. Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis, followed by human metapneu movirus, parainfluenza virus, adenovirus and influenza virus. RSV causes seasonal outbreaks, usually between winter and early spring in t emperate climates [1].Almost all infants and children are infected with RSV in the first 2 years of life [1], with tremendous societal impact. In 2002, approxi mately 149,000 US patients were hospitalized with bronchiolitis with a mean length of stay of 3.3 days. The estimated annual cost of bron chiolitisrelated hospitalizations during that time was over US $500 million [2]. Overall, h ospitalization rates for RSV are increasing [102].Despite the fact that bronchiolitis is common, costly and responsible for substantial morbid ity and mortality, there is no proven effective preventive measure or treatment. Several meta analyses and Cochrane reviews have concluded that bronchodilators, epinephrine and corticoste roids have no role in the routine care of children with bronchiolitis [3][4][5][6][7]. In addition, the routine use of a chest xray (CXR) in the diagnosis of The Institute of Medicine defines quality as "The degree to which health services for indi viduals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge [101]." The six domains of quality have been defined as safe, timely, effective, efficient, equitable and patientcentered care.Pediatricians have learned a tremendous amount regarding the quality of care for com mon respiratory illness over the past several decades; however, that knowledge has not always translated into clinical practice. This discrepancy reinforces what we know to be true; there remains a gap between evidencebased k nowledge and evidencebased practice.To assess the quality of care for common respi ratory infections in pediatrics, we will summa rize current therapeutic practice and highlight recent developments for bronchiolitis, croup, and communityacquired pneumonia (CAP). These infections are common in children, and each has an evidence base from which to make diagnostic and treatment decisions. This discus sion will review recent advances as well as c urrent shortfalls in quality of care.Our search for advances and shortfalls in qual ity focused on clinical practice guidelines (CPGs) derived from graded studies using standards of evidencebased medicine as well as expert pan els, systematic reviews, metaanalyses, random ized, controlled trials (RCTs) and policy state ments also d...

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Glucocorticoids for acute viral bronchiolitis in infants and young children

Cited by 34 publications

References 61 publications

Clinical characteristics of respiratory syncytial virus infection in neonates and young infants

Clinical characteristics of respiratory syncytial virus infection in neonates and young infants

Respiratorische Notfälle im Kindes- und Jugendalter

Quality of Care for Common Pediatric Respiratory Infections: Shortfalls and Improvements

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