Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- presencia de factores de riesgo
- tos
- taquipnea
- sibilancia
- retracciones, gruñidos y aleteo nasal
Otros factores de diagnóstico
- rinitis
- fluctuación de los hallazgos clínicos
- irritabilidad, malestar general y mala alimentación
- fiebre <40 °C (<104 °F)
- crepitaciones
- apnea
- asincronía toracoabdominal
Factores de riesgo
- lactantes <3 años
- meses de invierno
- prematuridad o displasia broncopulmonar
- exposición pasiva al humo de tabaco y contaminación atmosférica
- alteración de la depuración y la función de las vías respiratorias
- cardiopatía congénita
- inmunodeficiencia
Pruebas diagnósticas
Pruebas diagnósticas que deben considerarse
- detección de antígeno mediante ensayo de inmunoabsorción enzimática (ELISA) rápido
- radiografía de tórax
- reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR)
Algoritmo de tratamiento
Colaboradores
Autores
Howard B. Panitch, MD
Professor
Division of Pulmonary Medicine
Children's Hospital of Philadelphia
Philadelphia
PA
Divulgaciones
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).
Agradecimientos
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.
Divulgaciones
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 por pares
Robert Welliver, MD
Professor of Pediatrics
Women and Children's Hospital
Buffalo
NY
Divulgaciones
RW declares that he has no competing interests.
Giovanni Piedimonte, MD
Wyeth Research Scholar Professor and Chair
Department of Pediatrics
WVU School of Medicine
Physician-in-Chief
WVU Children's Hospital
Morgantown
WV
Divulgaciones
GP declares that he has no competing interests.
H. Cody Meissner, MD
Professor of Pediatrics
Infectious Disease
Department of Pediatrics
Tufts-New England Medical Center
Boston
MA
Divulgaciones
HCM is an author of a number of references cited in this topic.
John Henderson, MBBS
Professor of Paediatric Respiratory Medicine
University of Bristol
Bristol
UK
Divulgaciones
JH declares that he has no competing interests.
Referencias
Artículos principales
McCulloh R, Koster M, Ralston S, et al. Use of intermittent vs continuous pulse oximetry for nonhypoxemic infants and young children hospitalized for bronchiolitis: a randomized clinical trial. JAMA Pediatr. 2015 Oct;169(10):898-904.Texto completo Resumen
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
Zhang L, Mendoza-Sassi RA, Wainwright CE, et al. Nebulised hypertonic saline solution for acute bronchiolitis in infants. Cochrane Database Syst Rev. 2023 Apr 4;4(4):CD006458.Texto completo Resumen
Liet JM, Ducruet T, Gupta V, et al. Heliox inhalation therapy for bronchiolitis in infants. Cochrane Database Syst Rev. 2015 Sep 18;(9):CD006915.Texto completo Resumen
Artículos de referencia
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