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Acute Bronchitis

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1. Continuous positive airway pressure (CPAP) for acute bronchiolitis in children. Full Text available with Trip Pro

Continuous positive airway pressure (CPAP) for acute bronchiolitis in children. Acute bronchiolitis is one of the most frequent causes of emergency department visits and hospitalisation in children. There is no specific treatment for bronchiolitis except for supportive treatment, which includes ensuring adequate hydration and oxygen supplementation. Continuous positive airway pressure (CPAP) aims to widen the lungs' peripheral airways, enabling deflation of overdistended lungs in bronchiolitis (...) . Increased airway pressure also prevents the collapse of poorly supported peripheral small airways during expiration. Observational studies report that CPAP is beneficial for children with acute bronchiolitis. This is an update of a review first published in 2015.To assess the efficacy and safety of CPAP compared to no CPAP or sham CPAP in infants and children up to three years of age with acute bronchiolitis.We conducted searches of CENTRAL (2017, Issue 12), which includes the Cochrane Acute Respiratory

2019 Cochrane

2. Acute bronchitis

Acute bronchitis Acute bronchitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Acute bronchitis Last reviewed: February 2019 Last updated: June 2018 Summary Cough is typically worse at night or with exercise; lasts >2 weeks in 50% and 4 weeks in 25% of patients; may be associated with bronchospasm and/or excessive mucus production. Diagnosis is primarily clinical. Other causes for acute cough such as pneumonia (...) , asthma, or postnasal drip should be ruled out if suspected. Treatment is aimed at symptom reduction until infection is resolved and bronchial damage repaired. Antibiotics are not recommended in the majority of patients. Complications are rare; the primary complication is a postbronchitis syndrome, which can produce a cough lasting several months. Definition Acute bronchitis is defined as a self-limiting lower respiratory tract infection, to distinguish this condition from common colds and other upper

2018 BMJ Best Practice

4. Effect of Nebulized Hypertonic Saline Treatment in Emergency Departments on the Hospitalization Rate for Acute Bronchiolitis: A Randomized Clinical Trial

Effect of Nebulized Hypertonic Saline Treatment in Emergency Departments on the Hospitalization Rate for Acute Bronchiolitis: A Randomized Clinical Trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2018 PedsCCM Evidence-Based Journal Club

5. Nebulised hypertonic saline solution for acute bronchiolitis in infants. Full Text available with Trip Pro

Nebulised hypertonic saline solution for acute bronchiolitis in infants. Airway oedema (swelling) and mucus plugging are the principal pathological features in infants with acute viral bronchiolitis. Nebulised hypertonic saline solution (≥ 3%) may reduce these pathological changes and decrease airway obstruction. This is an update of a review first published in 2008, and previously updated in 2010 and 2013.To assess the effects of nebulised hypertonic (≥ 3%) saline solution in infants (...) hypertonic saline alone or in conjunction with bronchodilators as an active intervention and nebulised 0.9% saline, or standard treatment as a comparator in children under 24 months with acute bronchiolitis. The primary outcome for inpatient trials was length of hospital stay, and the primary outcome for outpatients or emergency department trials was rate of hospitalisation.Two review authors independently performed study selection, data extraction, and assessment of risk of bias in included studies. We

2017 Cochrane

6. Antibiotics for acute bronchitis. Full Text available with Trip Pro

Antibiotics for acute bronchitis. The benefits and risks of antibiotics for acute bronchitis remain unclear despite it being one of the most common illnesses seen in primary care.To assess the effects of antibiotics in improving outcomes and to assess adverse effects of antibiotic therapy for people with a clinical diagnosis of acute bronchitis.We searched CENTRAL 2016, Issue 11 (accessed 13 January 2017), MEDLINE (1966 to January week 1, 2017), Embase (1974 to 13 January 2017), and LILACS (...) (1982 to 13 January 2017). We searched the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov on 5 April 2017.Randomised controlled trials comparing any antibiotic therapy with placebo or no treatment in acute bronchitis or acute productive cough, in people without underlying pulmonary disease.At least two review authors extracted data and assessed trial quality.We did not identify any new trials for inclusion in this 2017 update. We included

2017 Cochrane

7. Haemophilus influenzae oral vaccination for preventing acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease. Full Text available with Trip Pro

Haemophilus influenzae oral vaccination for preventing acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease. Chronic bronchitis and chronic obstructive pulmonary disease (COPD) are serious conditions in which patients are predisposed to viral and bacterial infections resulting in potentially fatal acute exacerbations. Chronic obstructive pulmonary disease is defined as a lung disease characterised by obstruction to lung airflow that interferes with normal (...) of acute exacerbations of chronic bronchitis and COPD in adults. To assess the effectiveness of NTHi vaccine in reducing NTHi colonising the respiratory tract during recurrent episodes of acute exacerbations of COPD.We searched the following databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (2017, Issue 1), MEDLINE (1946 to January 2017), Embase (1974 to January 2017), CINAHL (1981 to January 2017), LILACS (1985 to January 2017), and Web of Science (1955 to January 2017). We also

2017 Cochrane

8. Chronic Cough Related to Acute Viral Bronchiolitis in Children

Chronic Cough Related to Acute Viral Bronchiolitis in Children Chronic Cough Related to Acute Viral Bronchiolitis in Children CHEST Expert Panel Report Anne B. Chang, MBBS, PhD, MPH; John J. Oppenheimer, MD; Bruce K. Rubin, MD; Miles Weinberger, MD, FCCP; and Richard S. Irwin, MD, Master FCCP; on behalf of the CHEST Expert Cough Panel BACKGROUND: Acute bronchiolitis is common in young children, and some children develop chronic cough after their bronchiolitis. We thus undertook systematic (...) , no recommendations on using the interventions above could be formulated. CONCLUSIONS: The panel made several consensus-based suggestions and identi?ed directions for future studies to advance the ?eld of managing chronic cough post-acute bronchiolitis in children. CHEST 2018; 154(2):378-382 KEYWORDS: cough; evidence-based medicine; guidelines ABBREVIATIONS: KQ = key question; RCT = randomized controlled trial AFFILIATIONS: From the Division of Child Health (Dr Chang), MenziesSchoolofHealthResearch,Darwin

2018 American College of Chest Physicians

9. High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study)

High flow nasal cannula (HFNC) versus nasal continuous positive airway pressure (nCPAP) for the initial respiratory management of acute viral bronchiolitis in young infants: a multicenter randomized controlled trial (TRAMONTANE study) PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2017 PedsCCM Evidence-Based Journal Club

10. Is Nebulized Hypertonic Saline Solution Effective for Acute Bronchiolitis?

Is Nebulized Hypertonic Saline Solution Effective for Acute Bronchiolitis? TAKE-HOME MESSAGE Hypertonic saline solution is possibly effective in decreasing hospital admission and length of stay for infants with bronchiolitis. Is Nebulized Hypertonic Saline Solution Effective for Acute Bronchiolitis? EBEM Commentators Jennifer H. Chao, MD Division of Pediatric Emergency Medicine Department of Emergency Medicine SUNY Downstate Medical Center Brooklyn, NY Richard Sinert, DO Division of Research (...) , and there is a need for rigorously designed studies focused on emergency department–relevant outcomes to provide guidance for emergencyphysicians. Editor’s Note: This is a clinical synopsis, a regular feature of the Annals’ Systematic Review Snapshot (SRS) series. The source for this systematic review snapshot is: Zheng L, Mendoza-Sassi RA, Klassen TP, et al. Nebulized hypertonic saline for acute bronchiolitis: a systematic review. Pediatrics. 2015;136:687-701. http://dx.doi.org/10.1542/peds. 2015-1914. 1. Zheng

2017 Annals of Emergency Medicine Systematic Review Snapshots

11. Beta2-agonists for acute cough or a clinical diagnosis of acute bronchitis. (Abstract)

Beta2-agonists for acute cough or a clinical diagnosis of acute bronchitis. The diagnosis of acute bronchitis is made on clinical grounds and a variety of clinical definitions have been used. There are no clearly effective treatments for the cough of acute bronchitis. Beta2-agonists are often prescribed, perhaps because clinicians suspect many patients also have reversible airflow restriction (as seen in asthma or chronic obstructive pulmonary disease (COPD)) contributing to the symptoms.To (...) determine whether beta2-agonists improve acute bronchitis symptoms in people with no underlying pulmonary disease (such as asthma, COPD or pulmonary fibrosis).We searched the Cochrane Central Register of Controlled Trials (CENTRAL) 2015, Issue 5, MEDLINE (January 1966 to May 2015), EMBASE (1974 to May 2015), Web of Science (2011 to May 2015) and LILACS (1982 to May 2015).Randomised controlled trials (RCTs) which allocated people (adults, or children over two years of age) with acute bronchitis or acute

2015 Cochrane

12. Chest physiotherapy for acute bronchiolitis is ineffective and may be harmful

Chest physiotherapy for acute bronchiolitis is ineffective and may be harmful Chest physiotherapy for acute bronchiolitis is ineffective and may be harmful Discover Portal Discover Portal Chest physiotherapy for acute bronchiolitis is ineffective and may be harmful Published on 10 May 2016 doi: Chest physiotherapy for acute bronchiolitis in children under two has no benefits and may be harmful, according to a systematic review published by the Cochrane Collaboration. The research looked (...) condition) should not be given chest physiotherapy on the basis of having bronchiolitis. Share your views on the research. Why was this study needed? Acute bronchiolitis is a common viral infection in children under two, in which the airways become inflamed and narrowed. About 30% of infants will develop the disease in the first year of life, of which 2 to 3% will need admission to hospital. In severe cases children may have difficulty breathing and suffer lack of oxygen. Chest physiotherapy is used

2019 NIHR Dissemination Centre

13. Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old. Full Text available with Trip Pro

Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old. This Cochrane review was first published in 2005 and updated in 2007, 2012 and now 2015. Acute bronchiolitis is the leading cause of medical emergencies during winter in children younger than two years of age. Chest physiotherapy is sometimes used to assist infants in the clearance of secretions in order to decrease ventilatory effort.To determine the efficacy of chest physiotherapy in infants aged (...) less than 24 months old with acute bronchiolitis. A secondary objective was to determine the efficacy of different techniques of chest physiotherapy (for example, vibration and percussion and passive forced exhalation).We searched CENTRAL (2015, Issue 9) (accessed 8 July 2015), MEDLINE (1966 to July 2015), MEDLINE in-process and other non-indexed citations (July 2015), EMBASE (1990 to July 2015), CINAHL (1982 to July 2015), LILACS (1985 to July 2015), Web of Science (1985 to July 2015) and Pedro

2016 Cochrane

14. Less stringent target oxygen levels for acute bronchiolitis are safe and effective

Less stringent target oxygen levels for acute bronchiolitis are safe and effective Less stringent target oxygen levels for acute bronchiolitis are safe and effective Discover Portal Discover Portal Less stringent target oxygen levels for acute bronchiolitis are safe and effective Published on 1 December 2015 doi: This NIHR-funded trial found that acute bronchiolitis in children can be safely managed to a slightly lower target level of oxygen saturation than currently used. Setting the level (...) with supplemental oxygen, but there are variations in the levels recommended in national guidelines in different countries. The 2006 Scottish national guidelines on bronchiolitis recommend oxygen saturation 94% or higher, while the American Academy of Pediatrics and the WHO guidelines recommend a target of 90%. This trial, called BIDS, aimed to assess whether a target oxygen saturation of 90% would lead to faster resolution of cough in acute bronchiolitis compared to a target level of 94% or higher. What did

2018 NIHR Dissemination Centre

15. Continuous positive airway pressure (CPAP) for acute bronchiolitis in children. (Abstract)

Continuous positive airway pressure (CPAP) for acute bronchiolitis in children. Acute bronchiolitis is one of the most frequent causes of emergency department visits and hospitalisation in infants. There is no specific treatment for bronchiolitis except for supportive therapy. Continuous positive airway pressure (CPAP) is supposed to widen the peripheral airways of the lung, allowing deflation of over-distended lungs in bronchiolitis. The increase in airway pressure also prevents the collapse (...) including random sequence generation. The effect of CPAP on the need for mechanical ventilation in children with acute bronchiolitis was uncertain due to imprecision around the effect estimate (two RCTs, 50 participants; risk ratio (RR) 0.19, 95% CI 0.01 to 3.63; low quality evidence). Neither trial measured our other primary outcome of time to recovery. One trial found that CPAP significantly improved respiratory rate compared with no CPAP (one RCT, 19 participants; mean difference (MD) -5.70 breaths

2015 Cochrane

16. Lung Ultrasound Findings and Bronchiolitis Ultrasound Score for Predicting Hospital Admission in Children With Acute Bronchiolitis. (Abstract)

Lung Ultrasound Findings and Bronchiolitis Ultrasound Score for Predicting Hospital Admission in Children With Acute Bronchiolitis. The purposes of this study were to determine the benefit of the bronchiolitis ultrasound score (BUS) in predicting hospital admission in children with acute bronchiolitis and to characterize lung sonography findings.This prospective observational study was performed in an academic pediatric emergency department. Children younger than 24 months presenting (...) to the emergency department, diagnosed with acute bronchiolitis by 2 independent pediatricians were included in the study. Lung ultrasound was performed by a single sonographer, who was blinded to as much clinical information as possible. In addition, the treating physicians were blinded to the lung ultrasound findings. Logistic regression analysis models were used to identify admission predictors. Receiver operating characteristic analysis was used to evaluate the predictive value for effects of the BUS

2018 Pediatric Emergency Care

17. Do ß-2 Agonists for Acute Bronchitis Provide Any Benefit?

Do ß-2 Agonists for Acute Bronchitis Provide Any Benefit? TAKE-HOME MESSAGE Although there is no evidence to support the use of b-2 agonists in children with acute cough without air?ow restriction, limited evidence suggests that they may bene?t adults with an acute cough and wheezing but their use must be weighed against any adverse effects. Do b-2 Agonists for Acute Bronchitis Provide Any Bene?t? EBEM Commentators Daniel C. Kolinsky, MD Evan S. Schwarz, MD Washington University in St. Louis (...) School of Medicine Division of Emergency Medicine St. Louis, MO Results Therewereatotalof7studiesthat met inclusion criteria, with a total of 552 patients treated in a pri- mary care setting. The overall quality of the included studies per the Grading of Recommendations, Assessment, Development and Evaluations criteria was low to moderate for ef?cacy of b-2 ago- nists in acute cough or acute bronchitis. Because of signi?cant clinical heterogeneity among the trials, there was no overall com- parison

2016 Annals of Emergency Medicine Systematic Review Snapshots

18. Are Antibiotics Effective in the Treatment of Acute Bronchitis?

Are Antibiotics Effective in the Treatment of Acute Bronchitis? Systematic Review Snapshot TAKE-HOME MESSAGE In patients without underlying lung disease, antibiotics in acute bronchitis appear to decrease cough, but the clinical signi?cance of this decrease is uncertain. Their use should be weighed against the cost and potential adverse effects for treatment of a self-limiting disease. Are Antibiotics Effective in the Treatment of Acute Bronchitis? EBEM Commentators Manpreet Singh, MD (...) versus control (placebo/no treatment) in acute bronchitis. Clinically Improved Cough Night Cough Shorter Mean Cough Duration Reduction in Ill Feeling Days Reduction in Limited Activity Days Adverse Side Effects RR 1.07 RR 0.64 RR 0.67 MD -0.46 days MD -0.64 days MD -0.49 days RR 1.20 0.99 to 1.15* 0.49 to 0.85* 0.54 to 0.83* -0.87 to -0.04* -0.94 to -0.04* -0.94 to -0.04 CI 1.05 to 1.36* NNT 22 NNT 6 NNT 7 NNH 5 NNT, Number needed to treat; MD, mean difference; NNH, number needed to harm. *95% CI

2015 Annals of Emergency Medicine Systematic Review Snapshots

19. Efficacy and safety of HL301 in the treatment of acute bronchitis and acute exacerbation of chronic bronchitis: a phase 2, randomized, double-blind, placebo-controlled, multicenter study. (Abstract)

Efficacy and safety of HL301 in the treatment of acute bronchitis and acute exacerbation of chronic bronchitis: a phase 2, randomized, double-blind, placebo-controlled, multicenter study. The efficacy and safety of Chinese herbs for symptomatic treatment of bronchitis is not well established. We evaluated the efficacy and safety of a combination product of seven herbs (HL301) for the treatment of acute bronchitis (AB) and acute exacerbation of chronic bronchitis (AECB) using a randomized (...) , double-blind, placebo-controlled, multicenter trial design.A total of 160 patients with AB or with AECB were randomized to receive placebo or one of three doses of HL301 (0.6 g/day, 1.2 g/day, or 1.8 g/day) for a total of 7 days. The primary study endpoint was the change in bronchitis severity score (BSS) from the baseline visit (visit 2) to the end of treatment visit (visit 3). Other efficacy variables were percentage BSS systemic sign efficacy after treatment and change in individual BSS parameters

2017 Current medical research and opinion Controlled trial quality: predicted high

20. Prolonged slow expiration technique improves recovery from acute bronchiolitis in infants: FIBARRIX randomized controlled trial (Abstract)

Prolonged slow expiration technique improves recovery from acute bronchiolitis in infants: FIBARRIX randomized controlled trial To examine the effect of prolonged slow expiration respiratory physiotherapy treatment on the acute bronchiolitis severity scale and O2 saturation at short-time and at medical discharge in infants and the hospital stay.Randomized controlled trial.Infants' unit of university hospital.Infants with acute bronchiolitis ( N = 80).Infants were randomized into respiratory (...) treatment (RT) with prolonged slow expiration or treatment as usual (control) for one-week period.The primary outcomes were Acute Bronchiolitis Severity Scale score and O2 saturation, recorded shortly after each intervention during the stay and at medical discharge, and the hospital stay.The RT had a significantly lower Acute Bronchiolitis Severity Scale 10-minute after the first intervention (mean difference -1.7 points, 95% confidence interval (CI) -3.0 to -0.38), 2 hours after (-2.0 points, 95% CI

2018 EvidenceUpdates

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