Bronchiolitis Guidelines

Updated: Mar 25, 2018
  • Author: Nizar F Maraqa, MD, FAAP; Chief Editor: Russell W Steele, MD  more...
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Guidelines

Guidelines Summary

AAP releases updated guidelines for pediatric bronchiolitis

The American Academy of Pediatrics has released updated guidelines on the diagnosis, treatment, and prevention of bronchiolitis in children aged 1 to 23 months. The new guidelines emphasize the use of supportive care, including hydration and oxygen. [226, 110] Other recommendations include the following:

  • As multiple viruses may cause bronchiolitis, testing for specific viruses is not necessary.

  • Routine radiographic or laboratory studies are also not necessary. Diagnosis and assessment of bronchiolitis severity should be based on patient history and physical examination.

  • There is no need for a trial dose of a bronchodilator.

  • Otherwise healthy infants with gestational age of 29 weeks or more should not receive palivizumab to prevent respiratory syncytial virus infections. Infants under one year of age with hemodynamically significant heart disease or chronic lung disease of prematurity should be treated with palivizumab, up to a maximum of 5 monthly doses, during the respiratory syncytial virus season.

  • Risk factors for severe disease include age less than 12 weeks, prematurity, underlying cardiopulmonary disease, and immunodeficiency.

  • Epinephrine and chest physiotherapy should not be administered to infants and children with bronchiolitis.

 

The following guidelines may be helpful: