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Bronchiolitis

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 11 Sep 2025
Last updated: 12 Aug 2025

Summary

Definição

História e exame físico

Principais fatores diagnósticos

  • cough
  • tachypnea
  • wheezing
  • retractions, grunting, and nasal flaring
Detalhes completos

Outros fatores diagnósticos

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

Fatores de risco

  • 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
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • pulse oximetry
Detalhes completos

Tests to avoid

  • broad respiratory pathogen panels
Detalhes completos

Investigações a serem consideradas

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

Algoritmo de tratamento

AGUDA

confirmed bronchiolitis

Colaboradores

Autores

Howard B. Panitch, MD

Emeritus Professor

Division of Pulmonary and Sleep Medicine

Children's Hospital of Philadelphia

Philadelphia

PA

Declarações

HBP is a member of the American Thoracic Society's Guideline Committee, Long-Term Oxygen Therapy for Infants and Children, past Chair of the American College of Chest Physicians' Home Based Mechanical Ventilation and Neuromuscular Disease NetWork, a member of the ATS guideline committee on bronchopulmonary dysplasia (BPD), and a member of the current new guideline committee updating the BPD Statement. He is a member of the planning committee of the Pediatric Assembly of the American Thoracic Society, and receives royalties from Up-To-Date for the review of two topics (Spirometry in Children and Bronchopulmonary Dysplasia).

Agradecimentos

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.

Declarações

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.

Revisores

Michael D. Patrick, Jr. MD

Associate Professor of Pediatrics

The Ohio State University College of Medicine

Columbus

OH

Declarações

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.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

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

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

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.Texto completo  Resumo

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. Resumo

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.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

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