31756884
Descrição
Mapa Mental por Kiley Whalen, atualizado more than 1 year ago
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Criado por Kiley Whalen
mais de 3 anos atrás
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Acute Bronchiolitis
- Essentials for Dx
- Insidious onset of cough and dyspnea
- Irreversible airflow obstruction of PFT
- Minimal findings on CXR
- Risk Factors
Anotações:
- Toxic fumes, viral infections, organ transplantation, connective tissue disease
- Insidious onset of cough and dyspnea
- Pathophysiology
- Inflammation of bronchioles
- VIRAL
- Respiratory Syncytial Virus (RSV)
- Other
Anotações:
- Rhinovirus, adenovirus, influenza, parainfluenza
- Respiratory Syncytial Virus (RSV)
- Inflammation of bronchioles
- Risk Factors
- Infants 2 mo.-2yr.
- Other
Anotações:
- <6 mo, exposure to cigarette smoke, lack of breastfeeding, premature birth (<37 weeks), crowded conditions
- Infants 2 mo.-2yr.
- Presentation
- Viral Prodrome
Anotações:
- Fever, HA, nausea and vomiting, lethargy, myalgias; lasts 1-2 days
- Followed by: Respiratory Distress
Anotações:
- Wheezing, rales, tachypnea, nasal flaring, cyanosis, retractions
- Viral Prodrome
- Diagnosis
- CLINICAL Dx
- Pulse Oximetry
Anotações:
- Single best predictor in children
- Nasal Washings
Anotações:
- Using monoclonal antibody testing
- No imaging
Anotações:
- CXR shows as nonspecific
- CLINICAL Dx
- Management
- Supportive care
Anotações:
- Humidified O2, IV fluids, nebulized saline, cool mist humidifier, antipyretics
- If severe
- Mechanical Ventilation
- Mechanical Ventilation
- Immunosuppressed or heart/lung disease
- Ribavirin
- Ribavirin
- Medications
Anotações:
- Limited role
- Beta-agonists
- Nebulized racemic epinephrine
- Corticosteroids*
Anotações:
- *Not indicated unless hx of underlying reactive airway disease
- Prevention
- At High Risk: Palivizumab and HANDWASHING
Anotações:
- -During the first year of life for children <29 weeks -Symptomatic chronic lung disease of prematurity -Coronary heart disease (CHD) -Neuromuscular difficulties, immunodeficiency
- At High Risk: Palivizumab and HANDWASHING
- Supportive care
- Prognosis/Complications
- Various complications possible, including d/t tx
Anotações:
- Various complications are possible including those caused by therapy. In most cases, the disease is mild and self-limited.
- RSV bronchiolitis in immunosuppressed infants
Anotações:
- 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
- Various complications possible, including d/t tx
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