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2020 JUN 20 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators discuss new findings in Lung Diseases and Conditions - Bronchitis. According [...]

Bronchiolitis is the most common cause of lower respiratory tract infection and the leading reason for hospitalisation among infants in developed countries (Cambonie et al 2008: 1865). The majority of [...]

Rationale: The main hindrance to long-term success of lung transplantation is bronchiolitis obliterans syndrome (BOS), generally thought to be a manifestation of chronic allograft rejection. BOS is associated histologically with [...]

Objective: To assess the effect of heliox, a helium-oxygen mixture, on respiratory distress symptoms in young infants. Design: Prospective, randomized, double-blind study. Setting: Pediatric ICU (PICU) of a university hospital. [...]

Various reports have demonstrated the importance of small airway inflammation in the development of airflow limitation and progression of COPD. This hypothesis proposes that the pathogenesis of COPD mirrors a [...]

Study objectives: To assess the effect of palivizumab licensing for respiratory syncytial virus (RSV) prophylaxis on national pediatric ICU (PICU) admissions and on the need for mechanical ventilation due to [...]

Background: Iron content in lung allografts is increased after transplantation. It was hypothesized that this may lead to fibrosis and posttransplant bronchiolitis obliterans syndrome (BOS). Methods: In a prospective study, [...]

The sound of a small child breathing in gasps and wheezes can alarm even experienced ED nurses, and your assessment of this vulnerable patient is key to ensuring a good [...]

Objective: To determine the utility of inhaled hypertonic saline solution to treat infants hospitalized with viral bronchiolitis. Design: Randomized, double-blind, controlled trial. Fifty-two hospitalized infants (mean ± SD age, 2.9 [...]

Objective: To determine the utility of inhaled hypertonic saline solution to treat ambulatory infants with viral bronchiolitis. Design: Randomized, double-blind, controlled trial. Sixty-five ambulatory infants (mean ± SD age, 12.5 [...]

Context: Bronchiolitis is the most common lower respiratory tract infection in infancy. A recent Centers for Disease Control and Prevention report confirmed that hospitalization rates for bronchiolitis have increased 2.4-fold from 1980 to 1996. Controversies exist about optimal treatment plans. Milliman and Robertson recommend ambulatory care management; in case of hospitalization, the recommended length of stay is 1 day. Objectives: To relate actual practice variation for infants admitted with uncomplicated bronchiolitis to Milliman and Robertson's recommendations. Design: Prospective observational study. Setting: General care wards of 8 pediatric hospitals of the Child Health Accountability Initiative during the winter of 1998-1999. Patients: First-time admissions for uncomplicated bronchiolitis in patients not previously diagnosed as having asthma and who were younger than 1 year. Main Outcome Measures: Respiratory rate, monitored interventions, attainment of discharge criteria goals, and length of stay. Results: Eight hundred forty-six patients were included in the final analysis: 85.7% were younger than 6 months, 48.5% were nonwhite, and 64.1% were Medicaid recipients or self-pay. On admission to the hospital, 18.3% of the infants had respiratory rates higher than higher than 80 breaths per minute, 53.8% received supplemental oxygen therapy, and 52.6% received intravenous fluids. These proportions decreased to 1.9%, 33.8%, and 20.3%, respectively, 1 day after admission, and to 0.7%, 20.1%, and 8.6%, respectively, 2 days after admission. The average length of stay was 2.8 days (SD, 2.3 days). Conclusions: Milliman and Robertson's recommendations do not correspond to practice patterns observed at the hospitals participating in this study; no hospital met the Milliman and Robertson recommended 1-day goal length of stay. Administration of monitored intervention persisted past the second day of hospitalization.

Suang Huang Lian may be an effective Chinese herbal medicine (CHM) in the treatment of acute respiratory infection (ARI). Researchers reviewed 27 controlled trials of CHMs in ARI, and found that, while most concluded CHMs were superior to antibiotics in treating ARI, the studies were poorly designed and analyzed. Intravenous Suang Huang Lian, reported to relieve cough, loosen sputum, and antiviral and antiinflammatory properties, may be effective in pneumonia and bronchiolitis.

Objective: To study the effect of an educational intervention on the management of hospitalized infants with bronchiolitis. Design: Sequential, prospective cohort study. Setting: A 235-bed children's hospital with nearly all private rooms. Patients: Consecutively admitted, previously healthy children younger than 24 months with symptoms of bronchiolitis. The first cohort was enrolled between January 1 and January 21, 1996; the second cohort between January 29 and February 18, 1996, following a 1-week intervention period; the third (follow-up) cohort between December 1996 and February 1997. Intervention: Educational program and practice guidelines aimed at appropriate utilization of diagnostic tests, decreased antibiotic and bronchodilator use, increased compliance with isolation, decreased length of stay, and maintenance of quality care. Main Outcome Measures: Utilization of respiratory syncytial virus (RSV) enzyme immunoassay, initiation and duration of parenteral antibiotic therapy, number of nebulized bronchodilator treatments, isolation orders, length of stay, and readmission rate. Results: A total of 90 patients were studied preintervention, 63 postintervention, and 90 during the follow-up period. The groups were comparable in demographic and clinical features. No patient had a documented serious bacterial infection; however, almost half in each group received parenteral antibiotics, despite recommendations against this. Immediately postintervention, children with positive RSV test results received antibiotics on fewer days than other children (median 0.6 vs 2.4 days; P =.004), suggesting that physicians stopped treatment with antibiotics once a viral diagnosis was confirmed. This effect did not persist into the follow-up period. Viral testing was reduced and isolation orders increased. Use of bronchodilators was reduced from 91% preintervention to 80% during the follow-up period (P = .046), and the median number of treatments was reduced from 15.0 to 10.0 (P = .005). There was no change in length of stay, which was 2 to 3 days, or in readmission rate, which was 1% to 4%. Conclusions: Educational efforts centered around practice guidelines can improve some aspects of the treatment of patients hospitalized with bronchiolitis. Arch Pediatr Adolesc Med. 1998; 152: 739- 744, Practice guidelines to standardize the care of bronchiolitis may be beneficial. Bronchiolitis is an inflammation of the lung for which there are few effective treatments. Researchers analyzed the use of ineffective treatments for bronchiolitis in groups of children hospitalized before and after an educational intervention using practice guidelines. Almost half the children received antibiotics even after the intervention despite the fact that none had a documented bacterial infection. Bronchodilator use was slightly reduced after the intervention, but there was no change in length of stay or re-admission rates.

Objective: To investigate whether nebulized racemic epinephrine or albuterol improves respiratory distress in infants with acute bronchiolitis. Design: A randomized, placebo-controlled, double-blind study. Setting: A university hospital providing primary hospital care for all pediatric patients in a defined area. Patients: One hundred consecutive infants younger than 24 months treated in the hospital for acute bronchiolitis. Intervention: The patients received two inhalations at 30-minute intervals: racemic epinephrine followed by physiologic saline (REP group; n=24), albuterol followed by physiologic saline (AP group; n=27), physiologic saline followed by racemic epinephrine (PRE group; n=24), and physiologic saline followed by albuterol (PA group; n=25). All patients received intramuscular epinephrine 60 minutes after the beginning of the study. Main Outcome Measures: Oxygen saturation, respiratory rate, and two clinical scores were used: one based on wheezing and retractions (Respiratory Distress Assessment Instrument) and the other based, on changes in wheezing, retractions, and respiratory rate (Respiratory Assessment Change Score). Main Results: During the study, there were no significant differences among the four groups in clinical scores, oxygen saturations, and respiratory rates. Mean Respiratory Distress Assessment Instrument scores improved significantly within the REP, PRE, and AP groups 15 minutes after the first inhalation. In only the REP group, which received racemic epinephrine, the confidence limits did not overlap. A comparison of paired data of each patient revealed that the difference in Respiratory Assessment Change Score was significant between racemic epinephrine and physiologic saline, but not between albuterol and physiologic saline. Intramuscular epinephrine significantly improved Respiratory Distress Assessment Index scores in those groups treated earlier with racemic epinephrine (REP and PRE groups). No significant adverse effects were seen in any group or at any phase of the study. Conclusions: Elimination of hypoxia by supplemental oxygen and moistening of inspired air relieve the symptoms of acute bronchiolitis. Nebulized racemic epinephrine and albuterol are safe and useful in the treatment of acute bronchiolitis. Improvements in symptom scores at 15 minutes favor the use of racemic epinephrine. As the action of epinephrine is short, the effect can be increased by repeated inhalations. (Arch Pediatr Adolesc Med. 1995;149:686-692), Inhaled epinephrine appears to be superior to inhaled albuterol in relieving breathing difficulties in young children with bronchiolitis. However, air moistened with saline also relieved symptoms. Bronchiolitis is an acute viral inflammation of the breathing passages which can cause them to swell shut, obstructing breathing. One hundred children younger than 24 months who were admitted to the hospital with wheezing and respiratory distress were randomly assigned to one of the following procedures: inhaled epinephrine followed 30 minutes later by salt water mist; albuterol followed by salt water mist; salt water followed by epinephrine; or salt water followed by albuterol. Symptoms of respiratory distress were scored as were changes in score after treatment. Salt water mist and both medications resulted in decrease of respiratory symptoms, but epinephrine showed the greatest effect. No significant side effects were seen in any group.

By a News Reporter-Staff News Editor at Women's Health Weekly -- Investigators publish new report on Oncology. According to news reporting out of Smithtown, New York, by NewsRx editors, research [...]

Extracorporeal membrane oxygenation (ECMO) is a method of oxygenating the blood using an artificial membrane located outside of the body. It is method of cardiopulmonary support for patients with severe lung disease. Although ECMO-related complications have decreased, and survival of infants treated with ECMO has increased, it is an expensive and risky treatment. For ECMO to be accepted for use in the pediatric population, the cost-to-benefit analysis and risks associated with ECMO use must be evaluated. ECMO is currently used when all other conventional therapies have failed. Successful treatment with ECMO in a infant born after 26 weeks of pregnancy prompted an analysis of all ECMO-treated infants with respiratory syncytial virus (RSV) bronchiolitis, a viral infection of the bronchiole structures of the airways causing respiratory failure. Between 1983 and 1988, 12 infants were treated with ECMO in nine centers. Eight of the infants were born prematurely, and five infants had abnormal lung development (bronchopulmonary dysplasia). The average age of the patient when the virus was contracted was 108 days old. Non-ECMO artificial ventilation was used for an average of 7.8 days before ECMO was initiated. Of the 12 infants, seven survived (four of the five with bronchopulmonary dysplasia). The average length of ECMO use was 233 hours. The six surviving infants have developed normally and one has slight motor delays. ECMO may be a life-saving intervention in infants with RVS bronchiolitis that is unresponsive to conventional ventilation techniques. (Consumer Summary produced by Reliance Medical Information, Inc.)

Acute bronchiolitis is a common respiratory illness in children under 12 months of age. Although much is known about the pathological features and manifestations of bronchiolitis, the optimal treatment for this condition if still unavailable. Various treatment modalities have been championed over the last few decades, with varying degree of success. The author has critically reviewed the most current literature on the effectiveness of some commonly used outpatient treatment modalities in the management of bronchiolits. Keywords: Bronchiolitis | Bronchodilators | glucocorticosteroid | hypertonic saline | anti-cholinergic | infant, Introduction Bronchiolitis is one of the most common respiratory problems in the first year of life (1). It is an inflammation of the bronchioles and most cases are viral in [...]

FROM PEDIATRICS The main treatment for bronchiolitis in young children should be support and observation, according to new clinical practice guidelines for diagnosing, managing, and preventing bronchiolitis. The guidelines apply [...]