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In healthy infants, bronchiolitis is generally a benign disease with good progression. In the majority of cases, treatment only involves supportive measures for maintaining sufficient hydration and oxygenation at home (always following consultation with a paediatrician).
Antibiotics are not useful in these cases. They are only effective in bacterial infections, and bronchiolitis is caused by a virus.
Treatment depends on the severity of the bronchiolitis, and usually includes:
As well as supportive measures, treatment with inhaled bronchodilators may benefit some patients by improving the openings of the bronchi and bronchioles.
Where necessary, in patients with oxygen saturation under 95%, hypoxia is corrected by administering oxygen with a face mask.
Supportive measures include:
Maintaining proper oral hydration, offering the infant fluids by feeding them small amounts frequently (in patients with mild bronchiolitis who do not have problems with feeding). Infants with breathing difficulties may need to have intravenous fluids administered.
Physiological saline solution nasal washes and aspirating secretions to relieve nasal congestion, especially before eating, inhaled therapies and sleep.
Maintaining a semi-recumbent position, face up.
The following is not recommended:
Passive smoking. It is important that parents are aware of the dangers of exposing their child to tobacco smoke. Studies show that rates of hospitalisation for infants with bronchiolitis are higher in smoking families than non-smoking families.
Air humidification/nebulisation. There are very few studies evaluating the role this measure plays in treating bronchiolitis, and none has been able to demonstrate the benefits of this. Very few vapour droplets reach the bronchial tubes, and there is also the possibility of adverse effects. For these reasons, its use is not recommended.
Respiratory physiotherapy is not routinely recommended.
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Published: 14 September 2021
Updated: 14 September 2021
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