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Bronchiolitis

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  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Evidence last reviewed: 10 Mar 2026
Topic last updated: 03 Mar 2026

Summary

Определение

Анамнез и осмотр

Ключевые диагностические факторы

  • cough
  • tachypnea
  • wheezing
  • retractions, grunting, and nasal flaring
Полная информация

Другие диагностические факторы

  • rhinitis
  • fluctuating clinical findings
  • irritability, malaise, and poor feeding
  • fever <104°F (<40°C)
  • crackles
  • apnea
  • thoracoabdominal asynchrony
Полная информация

Факторы риска

  • children <2 years
  • winter months
  • prematurity or bronchopulmonary dysplasia
  • passive tobacco smoke exposure and air pollution
  • impaired airway clearance and function
  • congenital heart disease
  • immunodeficiency
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • pulse oximetry
Полная информация

Tests to avoid

  • broad respiratory pathogen panels
Полная информация

Исследования, проведение которых нужно рассмотреть

  • enzyme-linked immunosorbent assay (ELISA) rapid antigen detection
  • chest x-ray
  • reverse transcriptase polymerase chain reaction (RT-PCR)
Полная информация

Алгоритм лечения

Острый

confirmed bronchiolitis

Составители

Авторы

Howard B. Panitch, MD

Emeritus Professor

Division of Pulmonary and Sleep Medicine

Children's Hospital of Philadelphia

Philadelphia

PA

Раскрытие информации

HBP is a medical editor for the Pediatric Pulmonology SubBoard of the American Board of Pediatrics. He has also been an expert witness for medical malpractice cases, but none involving infants with bronchiolitis. HBP has received royalties from Up to Date for chapter reviews. He has been on three guideline committees for the American Thoracic Society, one involving an update on the care of infants with bronchopulmonary dysplasia, one on the care of children with tracheostomies, and he is currently on one regarding the care of patients with Duchenne Muscular Dystrophy.

Выражение благодарностей

Professor Panitch would like to gratefully acknowledge Dr Isaac Desheng Liu, Dr Woon Li Seo, Dr Jennifer L. Nayak, Dr Caroline B. Hall, and Dr Clement L. Ren, previous contributors to this topic.

Раскрытие информации

IDL, WLS, JLN, and CLR declare that they have no competing interests. CBH is an author of a number of references cited in this topic.

Рецензенты

Michael D. Patrick, Jr. MD

Associate Professor of Pediatrics

The Ohio State University College of Medicine

Columbus

OH

Раскрытие информации

MDP declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

American Academy of Pediatrics Publications. AAP recommendations for the prevention of RSV disease in infants and children​. Jul 2025 [internet publication].Полный текст

Canadian Paediatric Society. Bronchiolitis: recommendations for diagnosis, monitoring and management of children one to 24 months of age. Nov 2021 [internet publication].Полный текст

Cunningham S, Rodriguez A, Adams T, et al. Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial. Lancet. 2015 Sep 12;386(9998):1041-8.Полный текст  Аннотация

Lin J, Zhang Y, Xiong L, et al. High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis. Arch Dis Child. 2019 Jun;104(6):564-76. Аннотация

Farley R, Spurling GK, Eriksson L, et al. Antibiotics for bronchiolitis in children under two years of age. Cochrane Database Syst Rev. 2014 Oct 9;(10):CD005189.Полный текст  Аннотация

Статьи, указанные как источники

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