Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- cough
- tachypnea
- wheezing
- retractions, grunting, and nasal flaring
Outros fatores diagnósticos
- rhinitis
- fluctuating clinical findings
- irritability, malaise, and poor feeding
- fever <104°F (<40°C)
- crackles
- apnea
- thoracoabdominal asynchrony
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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- pulse oximetry
Tests to avoid
- broad respiratory pathogen panels
Investigações a serem consideradas
- enzyme-linked immunosorbent assay (ELISA) rapid antigen detection
- chest x-ray
- reverse transcriptase polymerase chain reaction (RT-PCR)
Algoritmo de tratamento
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
Divulgaciones
MDP declares that he has no competing interests.
Agradecimiento de los revisores por pares
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Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
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 Resumen
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. Resumen
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 Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Bacterial pneumonia
- Chlamydial pneumonia
- Cystic fibrosis (CF)
Más DiferencialesGuías de práctica clínica
- Australasian bronchiolitis guideline
- 2022 Italian guidelines on the management of bronchiolitis in infants
Más Guías de práctica clínicaFolletos para el paciente
Bronchiolitis
Asthma in children
Más Folletos para el paciente
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