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Bronquiolite

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Última revisão: 17 Jan 2026
Última atualização: 12 Aug 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • presença de fatores de risco
  • tosse
  • taquipneia
  • sibilância
  • retrações, gemência e batimento da asa do nariz
Detalhes completos

Outros fatores diagnósticos

  • rinite
  • achados clínicos variáveis
  • irritabilidade, mal-estar e baixa aceitação alimentar
  • febre <40 °C (<104 °F)
  • estertores
  • apneia
  • assincronia toracoabdominal
Detalhes completos

Fatores de risco

  • crianças <2 anos
  • meses do inverno
  • prematuridade ou displasia broncopulmonar
  • exposição passiva à fumaça de cigarro e à poluição do ar
  • desobstrução das vias aéreas e função prejudicadas
  • cardiopatia congênita
  • imunodeficiência
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • oximetria de pulso
Detalhes completos

Investigações a serem consideradas

  • detecção rápida de antígeno por ensaio de imunoadsorção enzimática (ELISA)
  • radiografia torácica
  • reação em cadeia da polimerase via transcriptase reversa (RT-PCR)
Detalhes completos

Novos exames

  • pletismografia respiratória por indutância (PRI)
  • tomografia de impedância elétrica (TIE)

Algoritmo de tratamento

AGUDA

bronquiolite confirmada

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.

Disclosures

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.

Peer reviewers

Michael D. Patrick, Jr. MD

Associate Professor of Pediatrics

The Ohio State University College of Medicine

Columbus

OH

Disclosures

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.

References

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.

Key articles

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

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

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.Full text  Abstract

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. Abstract

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.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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