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Latest & greatest articles for bronchiolitis
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Bronchiolitis is mainly caused by the respiratory syncytial virus (RSV). The virus travels down to the bronchioles in the lungs causing them to become inflamed making it difficult to breath.
Almost every child will be infected with RSV by the time they reach two years. Adults can also contract the virus, typically during winter months.
In mild cases bronchiolitis will clear up without treatment. The virus that causes bronchiolitis travels through tiny droplets of liquid and can be passed through the air or contracted by touching infected surfaces.
Symptoms include: Sore throat, dry cough, blocked nose and aches and pains throughout the body.
Although there is no cure for chronic bronchiolitis research and clinical studies on bronchiolitis suggest that some lifestyle changes can ease symptoms: avoid smoking, eat a healthy diet and maintain regular exercise. In extreme cases steroids can be prescribed to help minimise inflammation.
Read more on medications used to treat bronchiolitis and the causes of the virus.
Airway Mucin Concentration as a Marker of Chronic Bronchitis. Chronic obstructive pulmonary disease (COPD) is characterized by chronic bronchitic and emphysematous components. In one biophysical model, the concentration of mucin on the airway surfaces is hypothesized to be a key variable that controls mucus transport in healthy persons versus cessation of transport in persons with muco-obstructive lung diseases. Under this model, it is postulated that a high mucin concentration produces (...) mucins MUC5AC and MUC5B were quantitated by means of mass spectrometry. Data from chronic-bronchitis questionnaires and data on total mucin concentrations in sputum were also analyzed in an independent 94-participant cohort.Mean (±SE) total mucin concentrations were higher in current or former smokers with severe COPD than in controls who had never smoked (3166±402 vs. 1515±152 μg per milliliter) and were higher in participants with two or more respiratory exacerbations per year than in those
Are leukotriene inhibitors useful for bronchiolitis? Bronchiolitis is a prevalent disease in children under two years of age, which carries significant morbidity and mortality. However, there is controversy regarding the optimal therapeutic management. Leukotriene inhibitors have been proposed as an alternative, although its efficacy is not clear yet. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified two systematic reviews comprising six (...) trials addressing the question of this article. We extracted data, combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded leukotriene inhibitors might not decrease mortality levels on bronchiolitis patients and it is not clear whether they decrease length of hospital stay. They might reduce recurrent wheezing, but the certainty of the evidence is low, and they increase adverse effects.
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?
Network meta-analysis of success rate and safety in antibiotic treatments of bronchitis. The purpose of this study was to compare the relative efficacy and safety of different antibiotic drugs and recommend superior regimens in the treatment of bronchitis. With respect to the antibiotic comparisons against quinolones in terms of intention-to-treat patients, we concluded that quinolones had advantages over placebo, β-lactams, sulfonamides, and double β-lactams. Concerning treatment methods (...) -lactams and macrolides (OR =5.0, 95% CrI =2.1-12.0; OR =3.0, 95% CrI =1.7-5.4, respectively). Quinolones can be recommended as the superior treatment for bronchitis, in accordance with our cluster analysis with surface under the cumulative ranking curve. The primary outcomes of network meta-analysis indicated that quinolones showed the best performance among the 8 treatments studied, although β-lactams showed the lowest risk of adverse side effects. Quinolones are recommended as the primary treatment
Nebulised hypertonic saline inhalations do not shorten hospital stays in infants with bronchiolitis. 27111485 2017 03 10 2017 08 17 1651-2227 105 9 2016 Sep Acta paediatrica (Oslo, Norway : 1992) Acta Paediatr. Nebulised hypertonic saline inhalations do not shorten hospital stays in infants with bronchiolitis. 1036-8 10.1111/apa.13448 Heikkilä Paula P Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland. Korppi Matti M Tampere Center (...) for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland. eng Journal Article Meta-Analysis 2016 06 01 Norway Acta Paediatr 9205968 0803-5253 0 Saline Solution, Hypertonic IM Acta Paediatr. 2016 Sep;105(9):1006-8 27514006 Administration, Inhalation Bronchiolitis drug therapy Humans Infant Length of Stay Saline Solution, Hypertonic administration & dosage 2016 01 20 2016 03 21 2016 04 20 2016 4 26 6 0 2016 4 26 6 0 2017 3 11 6 0 ppublish 27111485 10.1111/apa
CDHR3 gene variation and childhood bronchiolitis. 28782631 2019 05 30 2019 05 30 1097-6825 140 5 2017 11 The Journal of allergy and clinical immunology J. Allergy Clin. Immunol. CDHR3 gene variation and childhood bronchiolitis. 1469-1471.e7 S0091-6749(17)31267-8 10.1016/j.jaci.2017.06.044 Husby Anders A COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen & Danish Pediatric Asthma Center, Gentofte Hospital, University (...) . Bønnelykke Klaus K COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Faculty of Health and Medical Sciences, University of Copenhagen & Danish Pediatric Asthma Center, Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark. eng R01 HL129735 HL NHLBI NIH HHS United States Letter Meta-Analysis Research Support, Non-U.S. Gov't 2017 08 04 United States J Allergy Clin Immunol 1275002 0091-6749 0 CDHR3 protein, human 0 Cadherins 0 Membrane Proteins AIM IM Bronchiolitis epidemiology
IV Magnesium Sulfate for Bronchiolitis: A Randomized Trial The goal of this study was to determine if IV magnesium, useful for severe pediatric asthma, reduces time to medical readiness for discharge in patients with bronchiolitis when added to supportive care.We compared a single dose of 100 mg/kg of IV magnesium sulfate vs placebo for acute bronchiolitis. Patients received bronchodilator therapy, nebulized hypertonic saline, and 5 days of dexamethasone if there was eczema and/or a family (...) history of asthma. Time to medical readiness for discharge was the primary efficacy outcome. Bronchiolitis severity scores and need for infirmary or hospital admission and for clinic revisits within 2 weeks were secondary outcomes. Cardiorespiratory instability onset was the safety outcome.A total of 162 previously healthy infants diagnosed with bronchiolitis aged 22 days to 17.6 months (median, 3.7 months) were enrolled. Approximately one-half of patients had eczema and/or a family history of asthma
High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): an open, phase 4, randomised controlled trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?
Systematic Review and Meta-Analysis of the Efficacy and Safety of Combined Epinephrine and Corticosteroid Therapy for Acute Bronchiolitis in Infants. Objective: To evaluate the effectiveness of combined epinephrine and corticosteroid therapy for acute bronchiolitis in infants. Methods: Four electronic databases (MEDLINE, EMBASE, CINAHL, and CENTRAL) were searched from their inception to February 28, 2017 for studies involving infants aged less than 24 months with bronchiolitis which assessed (...) therapy was more effective at improving oxygen saturation level (mean difference: -0.70; 95% confidence interval: -1.17 to -0.22, p = 0.004). There was no difference in the risk of serious adverse events in infants treated with the combined epinephrine and corticosteroid therapy. Conclusions: Combination treatment of epinephrine and dexamethasone was ineffective in reducing hospital admission and length of stay among infants with bronchiolitis.
Effect of Nebulized Hypertonic Saline Treatment in Emergency Departments on the Hospitalization Rate for Acute Bronchiolitis: A Randomized Clinical Trial Acute bronchiolitis is the leading cause of hospitalization among infants. Previous studies, underpowered to examine hospital admission, have found a limited benefit of nebulized hypertonic saline (HS) treatment in the pediatric emergency department (ED).To examine whether HS nebulization treatment would decrease the hospital admission rate (...) among infants with a first episode of acute bronchiolitis.The Efficacy of 3% Hypertonic Saline in Acute Viral Bronchiolitis (GUERANDE) study was a multicenter, double-blind randomized clinical trial on 2 parallel groups conducted during 2 bronchiolitis seasons (October through March) from October 15, 2012, through April 15, 2014, at 24 French pediatric EDs. Among the 2445 infants (6 weeks to 12 months of age) assessed for inclusion, 777 with a first episode of acute bronchiolitis with respiratory
Therapy options for chronic lung allograft dysfunction-bronchiolitis obliterans syndrome following first-line immunosuppressive strategies: A systematic review. Long-term success of lung transplantation is limited by the development of chronic lung allograft dysfunction (CLAD), of which bronchiolitis obliterans syndrome (BOS) is the most common form. This systematic review sought to identify the current evidence base for CLAD-BOS therapies after initial immunosuppressive treatment
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
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
Molecular characterization and phylogenetic analyses of virulent infectious bronchitis viruses isolated from chickens in Eastern Saudi Arabia Infectious bronchitis virus (IBV) is one of the major respiratory viral threats for chickens. Despite the intensive application of IBV vaccines, several outbreaks have been reported worldwide. Here, we report several IBV outbreaks in thirteen poultry farms in Eastern Saudi Arabia (ESA) from 2013 to 2014. The main goals of the current study were as follows
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 (...) of stay and hospital admission with hypertonic saline solution, although theseresultsneedtobetempered by the presence of substantial heterogeneity across studies because of inconsistency in de?ningbronchiolitis.Bronchiolitisis a clinical syndrome as opposed to a speci?c pathologic process. In everyday practice, the clinical pre- sentation of bronchiolitis overlaps that of a simple upper respiratory infection with an asthma exacerba- tion. Zheng et al 1 concluded that nebulized hypertonic saline
Systematic review of instruments aimed at evaluating the severity of bronchiolitis. No recent studies have performed a systematic review of all available instruments aimed at evaluating the severity of bronchiolitis. The objective of the present study was to perform a systematic review of instruments aimed at evaluating the severity of bronchiolitis and to evaluate their measurement properties.A systematic search of the literature was performed in order to identify studies in which (...) an instrument for evaluating the severity of bronchiolitis was described. Instruments were evaluated based on their reliability, validity, utility, endorsement frequency, restrictions in range, comprehension, and lack of ambiguity.A total of 77 articles, describing a total of 32 different instruments were included in the review. The number of items included in the instruments ranged from 2 to 26. Upon analyzing their content, respiratory rate turned out to be the most frequently used item (in 26/32, 81.3
Comparison of Pathogen Eradication Rate and Safety of Anti-bacterial Agents for Bronchitis: A Network Meta-analysis. A large number of population in both developing and developed countries are affected by bronchitis, among all the factors, bacterial infection was considered as a critical cause of acute exacerbations of chronic bronchitis. Although several anti-bacterial agents were proved to have the effect of alleviating bronchitis, their relative efficacies and potential side effects remained (...) not clear. We are keen to compare the pathogen eradication rate and safety of anti-bacterial agents for bronchitis. Relevant studies were searched in multiple sources and data were extracted from eligible studies. Then conventional meta-analysis and network meta-analysis (NMA) were conducted to determine the relative efficacy and safety of bronchitis medications. The efficacy of bronchitis medications was determined by using the outcome of pathogen eradication, including total pathogen eradication
The Effects of Inhaled Steroids on Recurrent Wheeze After Acute Bronchiolitis: A Systematic Review and Meta-Analysis of 748 Patients. Background. Acute bronchiolitis infection during infancy is associated with an increased risk of asthma later in life. The objective of this study was to determine if inhaled steroids are effective in preventing the development of recurrent wheeze or asthma following acute bronchiolitis. Methods. Multiple databases and bibliographies of selected references were (...) % confidence interval = 0.58-1.81). Conclusions. A course of inhaled steroids after acute bronchiolitis is not effective in preventing recurrent wheeze or asthma.
Complementary and alternative medicine for the treatment of bronchiolitis in infants: A systematic review. Bronchiolitis is a common cause of hospitalization among infants. The limited effectiveness of conventional medication has prompted the use of complementary and alternative medicine (CAM) as alternative or adjunctive therapy for the management of bronchiolitis.To determine the effectiveness and safety of CAM for the treatment of bronchiolitis in infants aged less than 2 years.A systematic (...) electronic search was performed in Medline, Embase, CINAHL, AMED, and Cochrane Central Register of Controlled Trials (CENTRAL) from their respective inception to June 30, 2016 for studies evaluating CAM as an intervention to treat bronchiolitis in infants (1 month to 2 years of age). The CAM could be any form of treatment defined by the National Center for Complementary and Integrative Health (NCCIH) and was utilized either as a single agent or adjunctive therapy. The predefined primary outcome
Non-invasive ventilation improves respiratory distress in children with acute viral bronchiolitis: a systematic review. Non-invasive ventilation (NIV) is a common treatment for bronchiolitis. However, consensus concerning its efficacy is lacking. The aim of this systematic review was to assess NIV effectiveness to reduce respiratory distress. Secondary objectives were to summarize the effects of NIV, identify predictive factors for failure and describe settings and applications.Literature (...) searches were conducted in MEDLINE/PubMed, PEDro, Cochrane, EMBASE, CINAHL, Web of Science, UpToDate, and SuDoc from 1990 to April 2015. Randomized controlled trials, controlled non-randomized trials and prospective studies of NIV (continuous positive airway pressure [CPAP], bi-level CPAP, or neurally-adjusted ventilator assist) for bronchiolitis in infants younger than 2 years were included.Fourteen studies were included, for a total of 379 children. Of these, 357 were treated with NIV as first