Acute Bronchiolitis

Description

PANCE FCM I (1. Respiratory Diseases (Infectious Disorders) Mind Map on Acute Bronchiolitis, created by Kiley Whalen on 15/06/2021.
Kiley Whalen
Mind Map by Kiley Whalen, updated more than 1 year ago
Kiley Whalen
Created by Kiley Whalen over 3 years ago
12
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Resource summary

Acute Bronchiolitis
  1. Essentials for Dx
    1. Insidious onset of cough and dyspnea
      1. Irreversible airflow obstruction of PFT
        1. Minimal findings on CXR
          1. Risk Factors

            Annotations:

            • Toxic fumes, viral infections, organ transplantation, connective tissue disease
          2. Pathophysiology
            1. Inflammation of bronchioles
              1. VIRAL
                1. Respiratory Syncytial Virus (RSV)
                  1. Other

                    Annotations:

                    • Rhinovirus, adenovirus, influenza, parainfluenza
                2. Risk Factors
                  1. Infants 2 mo.-2yr.
                    1. Other

                      Annotations:

                      • <6 mo, exposure to cigarette smoke, lack of breastfeeding, premature birth (<37 weeks), crowded conditions
                    2. Presentation
                      1. Viral Prodrome

                        Annotations:

                        • Fever, HA, nausea and vomiting, lethargy, myalgias; lasts 1-2 days
                        1. Followed by: Respiratory Distress

                          Annotations:

                          • Wheezing, rales, tachypnea, nasal flaring, cyanosis, retractions
                      2. Diagnosis
                        1. CLINICAL Dx
                          1. Pulse Oximetry

                            Annotations:

                            • Single best predictor in children
                            1. Nasal Washings

                              Annotations:

                              • Using monoclonal antibody testing
                              1. No imaging

                                Annotations:

                                • CXR shows as nonspecific
                              2. Management
                                1. Supportive care

                                  Annotations:

                                  • Humidified O2, IV fluids, nebulized saline, cool mist humidifier, antipyretics
                                  1. If severe
                                    1. Mechanical Ventilation
                                    2. Immunosuppressed or heart/lung disease
                                      1. Ribavirin
                                      2. Medications

                                        Annotations:

                                        • Limited role
                                        1. Beta-agonists
                                          1. Nebulized racemic epinephrine
                                            1. Corticosteroids*

                                              Annotations:

                                              • *Not indicated unless hx of underlying reactive airway disease
                                            2. Prevention
                                              1. At High Risk: Palivizumab and HANDWASHING

                                                Annotations:

                                                • -During the first year of life for children <29 weeks -Symptomatic chronic lung disease of prematurity -Coronary heart disease (CHD) -Neuromuscular difficulties, immunodeficiency
                                            3. Prognosis/Complications
                                              1. Various complications possible, including d/t tx

                                                Annotations:

                                                • Various complications are possible including those caused by therapy. In most cases, the disease is mild and self-limited. 
                                                1. RSV bronchiolitis in immunosuppressed infants

                                                  Annotations:

                                                  • In immunosuppressed infants and those with preexisting heart or lung disease, RSV bronchiolitis can result in any of the following:
                                                  • Acute ARDS, Bronchiolitis obliterans, CHF, Secondary infection, Myocarditis, Arrythmias Chronic lung disease
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