Bronchiolitis is a winter disease t...

Bronchiolitis is a winter disease that fall outs in children younger than couple years. It usually is associated with respiratory syncytial virus infection and proceeds in respiratory difficulty, wheezing, and chest crackles upon auscultation. The diagnosis often is made in children who have not had a history of wheezing, moreover it is difficult to distinguish this condition from asthma. Because there is no curative treatment, bronchodilators have been used to treat symptoms of bronchiolitis. In an abstract of a Cochrane systematic review, with commentary according to Turner and Evered, randomized studies evaluating bronchodilator therapy for bronchiolitis were reviewed.

To be included in the review, studies had to have a placebo-controlled design with issues related to symptoms and signs. one of the 20 studies included had the following limitations: (1) variation among the make subordinates with some of them having returning wheezes, and (2) failure to identify the clinical significance of symptom score improvements.

Use of bronchodilators did not improve oxygenation or change the rate or duration of hospitalization. Patients treated with bronchodilators had significantly more adverse issues including tachycardia, increased blood squeezing decreased oxygen saturation, flushing, hyperactivity, lengthened cough, and tremor.

The Cochrane systematic review authors end that bronchodilator use in children with bronchiolitis put forwards a modest, short-term improvement in clinical scores when symptoms are mild to moderately accurate Because of high cost and uncertain benefit, routine use of this therapy cannot be recommended

gymnast and Evered note that bronchodilators commonly are used with oxygen and intravenous fluids in children hospitalized with bronchiolitis. The minor symptomatic relief put forwarded by this treatment may not be worth the splendor and the potential for adverse adventures Routine use of bronchodilators probably is not appropriate. Further research to determine which children with bronchiolitis would benefit from bronchodilator therapy and what other therapies might be useful is needed

Kellner JD et al. Bronchodilators for bronchiolitis (Cochrane Review). In: The Cochrane Library. Issue 1 2004 Chichester, United Kingdom: John Wiley & Son Ltd; and gymnast TW, Evered LM. Are bronchodilators effective in bronchiolitis? Ann Emerg M November 2003;42:709-11

COPYRIGHT 2004 American Academy of Family Physicians

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