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J Infect Dis 2019 Feb 19. Epub 2019 Feb 19.

Department of Paediatrics, Imperial College, London, UK.

Isr Med Assoc J 2019 Feb;21(2):110-115

Department of Pediatrics A, Schneider Children's Medical Center, Petah Tikva, Israel.

Background: Respiratory syncytial virus (RSV)-related bronchiolitis is a common cause of morbidity in young infants. The recommendations for its passive prevention by palivizumab are currently under intensive debate.

Objectives: To elucidate the optimal prevention strategy by studying the morbidity of RSV disease under the current recommendations for palivizumab prophylaxis in Israel. Read More

J Med Virol 2019 Feb 14. Epub 2019 Feb 14.

Department of Experimental Pathology, Immunology and Microbiology.

Background: Pediatric cancer patients have a higher risk of morbidity and mortality due to respiratory viral infections than do other patient populations.

Objectives: To investigate the causative viruses of respiratory infections and their burden among pediatric cancer patients in Lebanon.

Study Design: Nasopharyngeal swabs along with clinical and demographic data were collected from pediatric cancer patients presenting febrile episodes with upper respiratory tract symptoms. Read More

Pediatrics 2019 Feb 13. Epub 2019 Feb 13.

Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.

Background: Monoclonal antibody to respiratory syncytial virus (RSV; palivizumab) is recommend for prophylaxis of high-risk infants during bronchiolitis seasons but not for RSV bronchiolitis treatment. Our aim was to determine if palivizumab would be helpful in young infants with acute RSV bronchiolitis.

Methods: Eligible infants ≤3 months old presenting to the pediatric emergency service with RSV-positive bronchiolitis requiring inpatient admission underwent double-blind random assignment to single-dose intravenous palivizumab (15 mg/kg) or placebo. Read More

Am J Transplant 2019 Feb 12. Epub 2019 Feb 12.

Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.

Chronic graft-versus-host disease is a leading cause of morbidity and mortality following allotransplant. Activated donor effector T-cells can differentiate into pathogenic T helper (Th)-17 cells and germinal center -promoting Tfollicular helper cells, resulting in cGVHD. Phosphoinositide-3-kinase-δ, a lipid kinase, is critical for activated T-cell survival, proliferation, differentiation, and metabolism. Read More

Eur J Pediatr 2019 Feb 12. Epub 2019 Feb 12.

Emergency Pediatric Department, Institute for Research and Health Care (IRCCS), Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy.

Bronchiolitis is the most common cause of hospitalization of children in the first year of life. The lung ultrasound is a new diagnostic tool which is inexpensive, non-invasive, rapid, and easily repeatable. Our prospective study was conducted in the emergency department and all patients underwent a routine clinical evaluation and lung ultrasound by the pediatricians who defined the clinical and the ultrasound score. Read More

Am J Respir Crit Care Med 2019 Feb 11. Epub 2019 Feb 11.

Univ Michigan, Internal Medicine, Ann Arbor, Michigan, United States ;

Rationale: "Non-infectious" pulmonary complications are significant causes of morbidity and mortality post allogeneic hematopoietic cell transplant. Early onset viral reactivations or infections are common after transplant. Whether the first onset viral infection causes "non-infectious" pulmonary complications is unknown. Read More

Emerg Med J 2019 Feb 6. Epub 2019 Feb 6.

Division of Pediatric Emergency Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.

Background: Serious bacterial infections in young infants with bronchiolitis are rare. Febrile infants <1 month old with bronchiolitis often receive a lumbar puncture (LP), despite limited data for this practice and lack of clinical practice guidelines for this population. The primary objective was to investigate practice patterns in performance of LPs in the ED management of febrile infants aged ≤30 days with bronchiolitis. Read More

Pediatr Crit Care Med 2019 Feb;20(2):128-135

All authors: Division of Pediatric Critical Care Medicine, Department of Pediatrics, UH Rainbow Babies & Children's Hospital, Cleveland, OH.

Objectives: Initial respiratory support with noninvasive positive pressure ventilation or high-flow nasal cannula may prevent the need for invasive mechanical ventilation in PICU patients with bronchiolitis. However, it is not clear whether the initial choice of respiratory support modality influences the need for subsequent invasive mechanical ventilation. The purpose of this study is to compare the rate of subsequent invasive mechanical ventilation after initial support with noninvasive positive pressure ventilation or high-flow nasal cannula in children with bronchiolitis. Read More

Pediatrics 2019 Jan 31. Epub 2019 Jan 31.

Cochrane Database Syst Rev 2019 01 31;1:CD010473. Epub 2019 Jan 31.

Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, Delhi, India, 110029.

Background: Acute bronchiolitis is one of the most frequent causes of emergency department visits and hospitalisation in children. There is no specific treatment for bronchiolitis except for supportive treatment, which includes ensuring adequate hydration and oxygen supplementation. Continuous positive airway pressure (CPAP) aims to widen the lungs' peripheral airways, enabling deflation of overdistended lungs in bronchiolitis. Read More

JAMA Pediatr 2019 Jan 28. Epub 2019 Jan 28.

Department of Pediatrics, Stanford University School of Medicine, Stanford, California.

Importance: Concomitant urinary tract infection (UTI) is a frequent concern in febrile infants with bronchiolitis, with a prior meta-analysis suggesting a prevalence of 3.3%. However, the definition of UTI in these studies has generally not incorporated urinalysis (UA) results. Read More

Hosp Pediatr 2019 Feb;9(2):121-128

Division of Hospitalist Medicine and.

Objectives: Hospitals are employing more nurse practitioners and physician assistants on inpatient pediatric units. With this study, we compared patient outcomes in high-volume inpatient diagnoses on pediatric hospital medicine services staffed by attending physician hospitalists and residents (hospitalist and resident service [HRS]) with 1 staffed by attending physician hospitalists and advanced practice providers (HAPPS).

Methods: A historical cohort study was implemented by using administrative data for patients admitted to HRS and HAPPS from 2007 to 2011 with asthma, bronchiolitis, cellulitis, and pneumonia with severity levels 1 and 2 for all-patient refined diagnosis-related groups. Read More

Pediatr Pulmonol 2019 Jan 22. Epub 2019 Jan 22.

Division of Pediatric Pulmonology and Sleep Disorders Laboratory, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece.

Objectives: Although progress has been made in the standardized interpretation of nocturnal oximetry in children with obstructive sleep-disordered breathing (SDB), no evidence exists on oximetry abnormalities in other respiratory disorders. We aimed to compare obstructive lung disease (OLD) and SDB regarding nocturnal oximetry parameters.

Methods: We analyzed oximetry recordings from children with (i) OLD (obliterative bronchiolitis; cystic fibrosis); (ii) snoring and adenotonsillar hypertrophy (SDB); and (iii) no respiratory disorder (controls). Read More

JMIR Med Inform 2019 Jan 22;7(1):e12591. Epub 2019 Jan 22.

Department of Pediatrics, University of Utah, Salt Lake City, UT, United States.

Background: In children below the age of 2 years, bronchiolitis is the most common reason for hospitalization. Each year in the United States, bronchiolitis causes 287,000 emergency department visits, 32%-40% of which result in hospitalization. Due to a lack of evidence and objective criteria for managing bronchiolitis, clinicians often make emergency department disposition decisions on hospitalization or discharge to home subjectively, leading to large practice variation. Read More

J Pediatric Infect Dis Soc 2019 Jan 17. Epub 2019 Jan 17.

Division of Pediatric Emergency Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.

One-fourth of patients with bronchiolitis seen in US emergency departments between 2007 and 2015 received antibiotics; 70% of them had no documented bacterial coinfection. Macrolides were prescribed in 38% of the cases. Antibiotic use did not decrease after national recommendations against routine prescribing. Read More

Am J Respir Crit Care Med 2019 Jan 18. Epub 2019 Jan 18.

Vanderbilt University, Pediatrics, Nashville, Tennessee, United States.

Allergy 2019 Jan 17. Epub 2019 Jan 17.

Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

J Allergy Clin Immunol 2019 Jan 14. Epub 2019 Jan 14.

Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.

Hosp Pediatr 2019 Feb 15;9(2):79-86. Epub 2019 Jan 15.

Divisions of Pediatric Hospital Medicine.

Objectives: To assess pediatric providers' perceptions on viral testing and to determine barriers to minimizing respiratory viral testing (RVT) in bronchiolitis.

Methods: A single-center, cross-sectional study was conducted and included 6 focus group discussions with pediatric providers. Questions were focused on identifying factors associated with obtaining RVT. Read More

J Paediatr Child Health 2019 Jan 6. Epub 2019 Jan 6.

Department of Paediatrics, University of Antwerp, Edegem, Belgium.

Aim: Bronchiolitis is one of the most common lower respiratory tract infections in young children, associated with significant morbidity, but limited therapeutic options. Nebulised hypertonic saline (HS) has been a supportive treatment until current guidelines advised against its routine use. Accordingly, the University Hospital of Antwerp recently changed their policies to stop using it, allowing us to evaluate retrospectively if HS influences the duration of respiratory support. Read More

Dev Period Med 2018 ;22(4):323-328

Department of Pediatrics, Chair of Pediatrics, Jagiellonian University Medical College, Krakow, Poland.

Objective: Aim: The aim of our study was to evaluate the adherence to the 2014 American Academy of Pediatrics guidelines for bronchiolitis.

Patients And Methods: Material and methods: The study measured the utility of diagnostic and therapeutic procedures in children with the first episode of bronchiolitis in their lives hospitalized at the University Children's Hospital in Krakow, Poland, between September 2014 and March 2015. The results were compared with the achievable benchmarks of care (ABCs) for hospitalized children with bronchiolitis. Read More

Health Sci Rep 2018 Jun 24;1(6):e38. Epub 2018 May 24.

Department of Medical Microbiology and Immunology Turku University Turku Finland.

Background And Aim: Bronchiolitis is a leading cause of hospitalization in infants and is associated with a risk of subsequent asthma. The innate immunity genes, such as those encoding toll-like receptors (TLRs), are likely to play a role in bronchiolitis and post-bronchiolitis outcome. Thus far, only one study has considered TLR5 genes in respiratory syncytial virus (RSV) bronchiolitis. Read More

Health Sci Rep 2018 Dec 12;1(12):e91. Epub 2018 Oct 12.

Department of Medicine Vanderbilt University Medical Center Nashville TN USA.

Aim: We sought to determine the proportion of bronchiolitis episodes attributable to respiratory syncytial virus (RSV) among ICD-9 coded infant bronchiolitis episodes which were tested for RSV.

Methods: Bronchiolitis healthcare encounters were extracted from Kaiser Permanente Northern California databases for years 2006 to 2009. We used ICD-9 codes for bronchiolitis to capture bronchiolitis-related healthcare encounters including hospital admissions (Hospitalization), emergency department visits (EDV), and outpatient visits (OPV). Read More

Pediatr Pulmonol 2019 Mar 6;54(3):297-302. Epub 2019 Jan 6.

Department of Microbiology, Faculty of Medicine, Zagazig University, Egypt.

Background: Acute lower respiratory infection (ALRI) is the leading cause of child mortality, especially in the developing world. Polymorphisms in the interleukin 4 (IL-4) gene have been linked to a variety of human diseases.

Objectives: To investigate whether the IL-4 -590C/T (rs2243250) polymorphism could be a genetic marker for susceptibility to ALRIs in young Egyptian children. Read More

Hosp Pediatr 2019 Feb 4;9(2):87-91. Epub 2019 Jan 4.

Morgan Stanley Children's Hospital, Columbia University Medical Center and.

Background And Objectives: Practice guidelines have been published for bronchiolitis and community-acquired pneumonia (CAP), but little is known about pediatricians' knowledge of and attitudes toward these guidelines since their publication.

Methods: We surveyed pediatric providers at 6 children's hospitals in the New York City area. Two vignettes, an infant with bronchiolitis and a child with CAP, were provided, and respondents were asked about management. Read More

Rev Med Virol 2019 Jan 4:e2026. Epub 2019 Jan 4.

Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

Respiratory syncytial virus (RSV) infection is the most common cause of bronchiolitis and pneumonia in the pediatric population worldwide. The immunopathology of RSV infection varies considerably and severe disease occurs only in a minority of the population. There are many factors (host, viral, and environmental) that contribute to the complicated disease phenotype. Read More

Hosp Pediatr 2019 Feb 3;9(2):142-143. Epub 2019 Jan 3.

Department of Pediatrics, University of Nebraska Medical Center and Children's Hospital and Medical Center, Omaha, Nebraska; and.

Hosp Pediatr 2019 Feb 3;9(2):73-78. Epub 2019 Jan 3.

Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Background And Objectives: The American Academy of Pediatrics 2014 bronchiolitis guidelines recommend against the routine use of continuous pulse oximetry (CPO) because it has been implicated in prolonging the length of stay (LOS). At our institution, infants admitted with bronchiolitis were monitored by using CPO during the entire hospital stay and intermittent desaturations <90% appeared to delay discharge. This quality improvement initiative was designed to reduce the LOS by decreasing the use of CPO in stable infants with nonsevere bronchiolitis. Read More

Pediatr Emerg Care 2018 Dec 27. Epub 2018 Dec 27.

Department of Pediatrics, Alberta Children's Hospital, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta.

Objectives: A previous randomized controlled trial showed that artificially elevating the pulse oximetry display resulted in fewer hospitalizations with no worse outcomes. This suggests that management decisions based mainly on pulse oximetry may unnecessarily increase health care costs. This study assessed the incremental cost of altered relative to true oximetry in infants with mild to moderate bronchiolitis. Read More

Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi 2018 Nov;34(11):977-981

Department of Pediatrics, Affiliated Hospital of Binzhou Medical University, Binzhou 256600, China.

Objective To investigate the relationship between changes in atrial natriuretic peptide (ANP) signal and GATA3 expression in peripheral blood of children with bronchiolitis, and to explore the possible mechanism of ANP signal in the pathogenesis of bronchiolitis.Methods 20 normal children, 16 children with mild bronchiolitis, and 14 medium-severe children were enrolled. ELISA was used to detect the level of ANP and interleukin-4(IL-4) in plasma. Read More

J Infect Dis 2018 Dec 25. Epub 2018 Dec 25.

Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

The relation of nasopharyngeal microbiota to the clearance of respiratory syncytial virus (RSV) in infants hospitalized for bronchiolitis is not known. In a multicenter cohort, we found 106 of 557 (19%) infants hospitalized with RSV bronchiolitis had the same RSV subtype 3 weeks later (i.e. Read More

Patient Educ Couns 2018 Dec 13. Epub 2018 Dec 13.

Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Canada. Electronic address:

Objective: To inform evidence-based knowledge products (i.e., infographics, videos, eBooks) of relevance to parents, we systematically reviewed evidence on parent experiences and information needs related to bronchiolitis. Read More

JCI Insight 2018 Dec 20;3(24). Epub 2018 Dec 20.

Department of Medicine, Translational Transplant Research Center, Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

CD4+ follicular helper T (Tfh) cells are specialized providers of T cell help to B cells and can function as pathogenic mediators of murine antibody-dependent chronic graft-versus-host disease (GvHD). Using a parent→F1 model of lupus-like chronic GvHD, in which Tfh cell and germinal center (GC) B cell differentiation occurs over 14 days, we demonstrate that absence of CD4+ T cell-expressed C5a receptor 1 (C5ar1) or pharmacological C5aR1 blockade abrogated generation/expansion of Tfh cells, GC B cells, and autoantibodies. In a Tfh cell-dependent model of chronic GvHD manifested by bronchiolitis obliterans syndrome (BOS), C5aR1 antagonism initiated in mice with established disease ameliorated BOS and abolished the associated differentiation of Tfh and GC B cells. Read More

Am J Respir Crit Care Med 2018 Dec 18. Epub 2018 Dec 18.

Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.

Rationale: A subset of infants are hyper-susceptible to severe/acute viral bronchiolitis (AVB), for reasons incompletely understood.

Objectives: To characterise the cellular/molecular mechanisms underlying infant AVB in circulating cells/local airways tissues.

Methods: PBMC and nasal scrapings were obtained from infants (<18mths) and children (>18mths-5yrs) during AVB and post-convalescence. Read More

Clin Pediatr (Phila) 2018 Dec 14:9922818816432. Epub 2018 Dec 14.

1 University of Oklahoma Health Science Center, Oklahoma City, OK, USA.

Objectives: Viral bronchiolitis is a frequent cause of pediatric hospitalization and respiratory failure. Procalcitonin (PCT) is a biomarker used to identify serious bacterial infection and can distinguish bacterial and viral infections. Concomitant bacterial pneumonia is not rare in viral bronchiolitis and can lead to a worse clinical course. Read More

Ital J Pediatr 2018 Dec 12;44(1):148. Epub 2018 Dec 12.

Neonatology-NICU Casilino General Hospital, via Casilina 1049, 00169, Rome, Italy.

During the last epidemic season of bronchiolitis (S2, years 2016-2017) we performed a single Centre analysis in inborn infant of 30-32 gestational age and age < 12 months who did not receive prophylaxis with palivizumab (PLV), in light of the current AIFA (Italian Drug Agency) guidelines restricting the time of the prophylaxis to those born < 30 weeks of gestational age. During that epidemic season, we observed a rising trend of bronchiolitis-related hospitalization and an increased rate of mechanical ventilation in preterm child compared to the previous one (S1, years 2015-2016) during which infants of this same gestational age received palivizumab (PLV) prophylaxis, according to the 2015 Italian Guidelines.In light of the revised AIFA guidelines (November 2017), allowing once again prophylaxis with PLV in infants of > 30 weeks gestational age, we decided to repeat our observation during the last epidemic season (S3, years 2017-2018), in order to compare ours infants of 30-32 gestational age with preterm of the same gestational age born in our unit in the previous seasons (S1 and S2), to evaluate the clinical impact of the different prophylaxis approaches. Read More

Acta Paediatr 2018 Dec 11. Epub 2018 Dec 11.

Department of Paediatrics, Isala, Zwolle, The Netherlands.

Aim: To investigate differences in palivizumab prescription rates between Dutch paediatricians, and the role of parent counselling in this practice variation.

Methods: A retrospective chart review of premature infants <32 weeks of gestation, aged less than six months at the start of the winter season, born between January 2012 and July 2014, in three secondary hospital-based paediatric practices in the Netherlands.

Results: We included 208 patients, 133 (64%) of whom received palivizumab. Read More

Hosp Pediatr 2019 Jan 7;9(1):46-50. Epub 2018 Dec 7.

American Academy of Pediatrics Julius B Richmond Center of Excellence, Elk Grove Village, Illinois; and.

Background And Objective: To determine if cigarette smoke exposure, marijuana smoke exposure, or cytokine levels at admission to the hospital for bronchiolitis are associated with follow-up visits for asthma.

Methods: We enrolled a cohort of children aged 31 days to 2 years who were hospitalized with bronchiolitis from January 2013 to April 2014. Data included the results of a baseline survey about children's health and demographics, nasal wash samples, the results of a 6-month postdischarge follow-up survey, and a chart review. Read More

Pediatrics 2019 Jan 5;143(1). Epub 2018 Dec 5.

Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.

Objectives: The American Academy of Pediatrics' bronchiolitis guidelines recommend against albuterol and corticosteroids for treating and chest radiographs (CRs) for diagnosing infants with bronchiolitis. However, high rates of nonadherence have been documented. Our objective was to improve guideline adherence in infants with bronchiolitis. Read More

Eur J Pediatr 2018 Dec 1. Epub 2018 Dec 1.

Paediatric Intensive Care, Hôpital Femme Mère Enfant, Nantes, France.

Feeding difficulties are common in young infants presenting with acute bronchiolitis, but limited data is available to guide clinicians adapting nutritional management. We aimed to assess paediatricians' nutritional practices among Western Europe French speaking countries. A survey was disseminated to describe advice given to parents for at home nutritional support, in hospital nutritional management, and preferred methods for enteral nutrition and for intravenous fluid management. Read More

Turk J Pediatr 2018 ;60(3):286-289

Division of Pediatric Pulmonology, Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Turkey.

Hüsrevoğlu-Esen F. Altuner-Torun Y, Karakükçü Ç, Köse S, Şehriyaroğlu A, Kafadar D, Esen A, Köse M. Gelsolin levels in patients with bronchiolitis. Read More

Drug Des Devel Ther 2018 8;12:3825-3845. Epub 2018 Nov 8.

Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan,

Purpose: Childhood reactive airway diseases (RADs) are concerning problems in children's airways and may be preceded by bronchiolitis and may progress to childhood asthma. The severity of the disease is indicated by deterioration in pulmonary functions, increased usage of rescue medications, and recurrent wheezing episodes. Macrolides have both antimicrobial and anti-inflammatory functions and have been used as adjunctive therapy in childhood RADs. Read More

Mymensingh Med J 2018 Oct;27(4):702-709

Dr Afroza Begom, Indoor Medical Officer, Department of Pediatrics, Mymensingh Medical College Hospital, Mymensingh, Bangladesh.

Pneumonia is the leading cause of morbidity and mortality in children less than 5 years of age in developing countries like Bangladesh. Although WHO guideline classified severe pneumonia by symptoms and signs of the patients, radiological and laboratory investigations were not studied well. There was increasing number of cases of bronchiolitis which meet the criteria of WHO classified severe pneumonia are reported. Read More

Pediatr Crit Care Med 2019 Feb;20(2):e70-e76

Division of Critical Care, Department of Pediatrics, Rainbow Babies and Children's Hospital, Cleveland, OH.

Objectives: New definitions of pediatric acute respiratory distress syndrome include criteria to identify a subset of children "at risk for pediatric acute respiratory distress syndrome." We hypothesized that, among PICU patients with bronchiolitis not immediately requiring invasive mechanical ventilation, those meeting at risk for pediatric acute respiratory distress syndrome criteria would have worse clinical outcomes, including higher rates of pediatric acute respiratory distress syndrome development.

Design: Single-center, retrospective chart review. Read More

J Pediatr 2019 Feb 14;205:112-119.e4. Epub 2018 Nov 14.

Lyon University Hospital, Hôpital Femme Mère Enfant, Medical Intensive Care Unit, Bron, France; University of Lyon, Université Claude Bernard Lyon 1, Villeurbanne, France; INSERM 955-Eq13, Institut Mondor de Recherche Biomédicale, Créteil, France.

Objective: To assess the effect of the prone position on physiological measures, including inspiratory effort, metabolic cost of breathing, and neural drive to the diaphragm as compared with the supine position in infants with severe bronchiolitis requiring noninvasive ventilation.

Study Design: Fourteen infants, median age 33 days (IQR [first and third quartiles], 25-58) were randomized to receive 7 cmHO continuous positive airway pressure for 1 hour in the prone position or in the supine position, which was followed by cross-over to the supine position and the prone position for 1 hour, respectively. Flow, esophageal, airway, gastric, and transdiaphragmatic pressures, as well as electrical activity of the diaphragm were simultaneously recorded. Read More

J Infect Dis 2018 Nov 16. Epub 2018 Nov 16.

Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.

Background And Objective: Bronchiolitis is associated with a greater risk of developing recurrent wheezing, but with currently-available tools, it is impossible to know which infants with bronchiolitis will develop this condition. This preliminary prospective study aimed to assess whether urine metabolome analysis can be used to identify bronchiolitis children at risk of developing recurrent wheezing.

Methods: 52 infants less than one year old treated at our department's ER for acute bronchiolitis were enrolled (77% RSV positive). Read More

Hosp Pediatr 2018 Dec 15;8(12):769-777. Epub 2018 Nov 15.

Department of Pediatrics, School of Medicine, University of Washington, Seattle, Washington.

Objectives: To assess (1) the accuracy of child immunization status documented by providers at hospital presentation for acute respiratory illness and (2) the association of provider-documented up-to-date (UTD) status with immunization receipt during and after hospitalization.

Methods: We conducted a retrospective cohort analysis of children ≤16 years old treated for asthma, croup, bronchiolitis, or pneumonia at a children's hospital between July 2014 and June 2016. Demographics, clinical characteristics, and provider-documented UTD immunization status (yes or no) at presentation were obtained from the medical record. Read More

Clin Rehabil 2018 Nov 16:269215518809815. Epub 2018 Nov 16.

6 Paediatric Neumology, Virgen Arrixaca University Children's Hospital, Murcia, Spain.

Objective:: To examine the effect of prolonged slow expiration respiratory physiotherapy treatment on the acute bronchiolitis severity scale and O saturation at short-time and at medical discharge in infants and the hospital stay.

Design:: Randomized controlled trial.

Setting:: Infants' unit of university hospital. Read More

J Pediatr Pharmacol Ther 2018 Sep-Oct;23(5):372-378

Objectives: Although no longer included in the American Academy of Pediatrics guideline, ribavirin was shown to be beneficial in a subset of adult patients with severe respiratory syncytial virus (RSV)-associated bronchiolitis. This study aimed to investigate risk factors for progression to severe acute respiratory tract infections in hospitalized pediatric patients with RSV-associated bronchiolitis to identify which patients may benefit from inhaled ribavirin therapy, despite its substantial cost, diffcult administration, and potential complications.

Methods: Patients were identified by ICD-9 codes for RSV bronchiolitis and were only included if they had a confirmed positive result for RSV via polymerase chain reaction for detection and typing of respiratory viruses. Read More