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Arch Hellen Med, 34(5), September-October 2017, 592-604


Current views on the treatment and prevention of acute bronchiolitis in children

M. Liaska, K. Tsoumakas
Pediatric Clinic, Department of Nursing, National and Kapodistrian University of Athens, "P. and A. Kyriakou" General Children's Hospital, Athens, Greece

Acute bronchiolitis is a common, well-studied, clinical entity characterized by significant morbidity in infants and young children. Its diagnosis is based primarily on the clinical picture and indications for the use of other diagnostic tools are minimal. Although this is usually a mild, self-limited disease, it is the leading cause of hospitalization during infancy. The significant morbidity of the disease and its economic impact in all developed countries has led to a large number of clinical trials and meta-analyses in the search for a safe and effective therapeutic strategy, in spite of which the role of pharmacological treatment remains controversial. The treatment of bronchiolitis is mainly supportive, focusing on the prevention of dehydration, hypoxia and respiratory failure. Pharmacological agents, including bronchodilators, corticosteroids and antibiotics, continue to be administered inappropriately, despite insufficient evidence of any positive effect on the clinical outcome of the disease. Currently, ribavirin is the unique available antiviral medication, but its side effects and toxicity limit its use. Positive conclusions have been reported regarding new treatment options, including hypertonic solutions and the non-invasive method of delivering oxygen at high flow, the high flow nasal cannula (HFNC). The failure, to date, of vaccine production against the respiratory syncytial virus (RSV), which is associated with the most severe clinical manifestations of the disease, makes it imperative to design effective preventive interventions, especially for high-risk groups. Although there has been remarkable progress in the efforts to produce a safe and effective vaccine, there are many obstacles on the road to achieving this goal.

Key words: Acute bronchiolitis, Children, Prevention, Treatment.

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