Bronchiolitis

Infection of the lower respiratory tract occurring mostly in young infants ages 2-24 months
- Most common etiology is RSV
   – Infants younger than 3 months with RSV are at significant
increased risk for apnea and therefore admission is indicated for monitoring,
under 6 weeks must be admitted to PICU.
- should obtain CXR and DFAs or rapid flu/RSV overnight
- Mainstay treatment is supportive
- Some patients are responders to albuterol and/or racemic epinephrine
- Bronchodilator therapy may be considered if there is a positive clinical response to an alpha-or beta-adrenergic medication during a carefully managed trial
- steroids not indicated for bronichiolitis as this point based on evidence

Suggested guidelines for admission are as follows:
- Oxygen saturation less than 94% after therapy
- Respiratory distress (eg, respiratory rate >60/min or retractions at rest)
- Apnea or risk of apnea
- Age younger than 3 months or history of prematurity
- Underlying cardiopulmonary disease or immunosuppression