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437651
Bronchiolitis
Description
Paediatrics (Respiratory) Mind Map on Bronchiolitis, created by v.djabatey on 12/12/2013.
No tags specified
paediatrics
respiratory
paediatrics
respiratory
Mind Map by
v.djabatey
, updated more than 1 year ago
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Created by
v.djabatey
almost 11 years ago
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Resource summary
Bronchiolitis
epidemiology
commonest serious respiratory infection of infancy
2-3% of all infants admitted to hospital/ yr during annual winter epidemics
90% of cases are 1-9 mths old
rare after 1 year of age
pathogen
virus
RSV
causes 80% of cases
highly infectious
human metapneumovirus
parainfluenza virus
rhinovirus
adenovirus
influenza
bacteria
Mycoplasma pneumoniae
clinical features
coryzal sx
followed by
dry cough
increasing breathlessness
feeding difficulty
assoc w/ increasing dyspnoea
often reason for hosp admission
on examination
sharp dry cough
tachypnoea
hyperinflation of chest
prominent sternum
liver displaced downwards
fine end-inspiratory crackles
+/- high pitched wheezes- exp> insp
tachycardia
cyanosis or pallor
subcostal & intercostal recession
complications
serious
recurrent apnoea
esp in young infants
< 4 mths old
high risk groups for severe bronchiolitis
premature infants
who developed bronchopulmonary dysplasia
w/ underlying lung disease
Cystic fibrosis
w/ congenital heart disease
Ix
nasopharyngeal secretions (aspirate?)
PCR
ID resp viruses
CXR
unnecessary in straightforward cases
rarely helpful in bronchiolitis
signs
hyperinflation of lungs
due to small airways obstruction
flattening of diaphragm
air trapping
focal atelectasis
horizontal ribs
increased hilar bronchial markings
pulse oximetry
continuous monitoring of arterial O2 sats
blood gas analysis
from capillary sample
done only in severe disease
to ID hypercarbia when additional ventilatory support is needed
Mx
supportive
humidified O2
via nasal cannulae
conc needed determined by pulse oximetry
monitoring
for apnoea
fluids
NG
IV
ventilation
assisted
nasal CPAP
facemask CPAP
full
infection control
Prognosis
most recover from acute infection within 2 weeks
1/2 will have recurrent episodes of cough and wheeze
rare
ff adenovirus infection
bronchiolitis obliterans
permanent damage to airways
prevention
palivizumab
monoclonal antibody to RSV
monthly i.m. injection
reduces risk of hosp admissions in high-risk preterm infants
costly
multiple i.m injections needed
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