Bronchiolitis clinical practice guidelines implementation: surveillance study of hospitalized children in Jordan

Awad, Samah; Hatim, Rawan; Khader, Yousef; Alyahya, Mohammad S.; Harik, Nada; Rawashdeh, Ahmad Al; Qudah, Walaa; Khasawneh, Ruba; Hayajneh, Wail A.; Yusef, Dawood

doi:10.4081/mrm.2020.673

Cited by 4 publications

(2 citation statements)

References 33 publications

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“… Country Bronchodilator (%) Glucocorticoid (%) Antibiotic (%) Brazil – 2022 100 98.3 62 Italy-Manti S . et al, 2021 37 39.6 64.5 4.7 Australia and New Zealand – Oakley S. et al, 2018 38 24.2 11.6 14.1 Jordan-Awad S. et al, 2020 39 31.9 5.5 16.5 Spain-Martinez D.A. et al, 2022 32 51.2 ‒ ‒ …”

Section: Discussionmentioning

confidence: 99%

Acute viral bronchiolitis phenotype in response to glucocorticoid and bronchodilator treatment

Chacorowski,

Lima,

Menezes

et al. 2024

Clinics

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Section: Discussionmentioning

confidence: 99%

Acute viral bronchiolitis phenotype in response to glucocorticoid and bronchodilator treatment

Chacorowski,

Lima,

Menezes

et al. 2024

Clinics

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“…10,11 The "American Academy of Pediatrics (AAP) does not recommend routine laboratory and radiological investigations but it is often seen that infants with acute bronchiolitis undergo extensive and needless diagnostic assessment. 12 In infants, bronchiolitis is often mild in nature that subsides without much interventions while some children may need hospital admissions. Researchers have estimated between 1 to 2.7% cases of acute bronchiolitis to warrant critical care support.…”

Section: Introductionmentioning

confidence: 99%

Outcome of Hypertonic Saline Versus Normal Saline in Children with Acute Bronchiolitis

Shahid¹,

Javeed²,

Wamiq³

2022

PJMHS

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Objective: To compare outcome of hypertonic saline (HS) versus normal saline (NS) among children aged 2 to 24 months with acute bronchiolitis. Study design: An open label randomized controlled trial. Place and Duration of the Study: Department of Pediatric Medicine, Ibn-e-Siena Hospital, Multan from 1st September 2021 to 31st March 2022. Methodology: A total of 220 children (110 in each group) of both genders aged 2 to 24 months reporting to emergency department with acute bronchiolitis with a disease spanning less than 5 days were included. In HS group, children were nebulized with 4 ml of 3% HS while in NS groups, all children were nebulized with 4ml 0.9% saline solution. In both groups, children were given respective treatment with interval gap of 4 hours. Clinical severity score and need for hospitalization after 24 hours was noted. Results: In a total of 220 children, 126 (57.3%) were males and 94 (42.7%) females. Overall, mean age was 7.9±5.3 months while 170 (77.3%) children were aged between 2 to 12 months. Residential status of 132 (60.0%) children was rural. Monthly family income of 165 (75.0%) children was below 25,000 Pakistani Rupees (PKR). Maternal educational status of 91 (41.4%) children was illiterate. Mean baseline clinical severity score was calculated to 7.28 ± 1.47. HS group, post-treatment mean clinical severity score was 4.29±2.83 in comparison to 5.99±2.64 in NS groups. There were 28 (25.5%) children in HS group who required hospitalization in comparison to 56 (50.9%) in NS group (p=0.0001) Conclusion: In comparison to nebulization with normal saline, nebulization with hypertonic saline solution was found to be significantly more effective in reducing clinical severity score and need for hospitalization among children aged up to 2 years with acute bronchiolitis. Keywords: Hypertonic saline, normal saline, acute bronchiolitis, clinical severity score.

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Practice in bronchiolitis management in Polish hospitals—a multicenter retrospective cohort study

Szupieńko,

Bojarska-Cikoto,

Woźny-Sędek

et al. 2024

Eur J Pediatr

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Bronchiolitis is one of the main reasons for the hospitalization of young children. Based on updated recommendations, only supportive therapy is recommended for treatment. In Poland, many children that are hospitalized with bronchiolitis undergo a treatment that is not supported by current research. The study aimed to assess clinicians’ adherence to the guidelines. This was a multicenter retrospective study of hospitalized infants with bronchiolitis; a cohort study design was utilized. Data were collected in four Pediatric Departments in Poland. All infants aged less than 24 months that had been hospitalized for their first and subsequent episodes of acute bronchiolitis from January 1, 2021, to December 31, 2022, were included. The exclusion criterion was an age over 24 months. A total of 629 infants with a median age of 8.5 months were included in this study. The medical interventions and treatments varied between the four hospitals. Laboratory blood tests were run for almost all children (99.5%), and the percentage of children for which a chest X-ray was performed ranged from 1.3% to 44%. The other measures were the use of intravenous hydration (51.3%-93.3%), use of hypertonic saline nebulization (1.3%-43.6%), use of normal saline nebulization (10%-95.1%), use of oxygen (7.3%-42%), use of beta-mimetics (19.1%-89.4%), use of nebulized steroids (8%-76.9%), use of systemic steroids (0.9%-42%), use of nebulized adrenaline (0%-8.1%), and use of antibiotics (12%-21.8%). Conclusions : In total, 70% of infants who were hospitalized in four hospitals in Poland underwent examinations and treatment methods that are not supported by current guidelines and evidence-based research. This study shows that non-recommended medications are overused in bronchiolitis treatment, and there is a need to take action to implement the guidelines into healthcare providers’ work. What is Known: • Bronchiolitis is a lower respiratory tract viral infection and is one of the main reasons for hospitalization among young children. • Only supportive therapy is recommended in the guidelines. • Bronchodilators, nebulized adrenaline, nebulized or systemic steroids, and antibiotics are not recommended. What is New: • Non-recommended medications are overused in bronchiolitis treatment in Poland. • Up to 70% of hospitalized children in the studied centers underwent treatment that is not supported by guidelines.

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Bronchiolitis clinical practice guidelines implementation: surveillance study of hospitalized children in Jordan

Cited by 4 publications

References 33 publications

Acute viral bronchiolitis phenotype in response to glucocorticoid and bronchodilator treatment

Acute viral bronchiolitis phenotype in response to glucocorticoid and bronchodilator treatment

Outcome of Hypertonic Saline Versus Normal Saline in Children with Acute Bronchiolitis

Practice in bronchiolitis management in Polish hospitals—a multicenter retrospective cohort study

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