Evaluation of the treatment used in cases of acute viral bronchiolitis diagnosed in the pediatric emergency room

Abstract

Introduction: Bronchiolitis is a viral disease that occurs in infants and is an important cause of hospitalization in this group. It has a benign course. The only treatment that is proven to be effective is supportive. Objectives: To evaluate the frequency of pharmacological and non-pharmacological treatments used in patients who received bronchiolitis diagnosis in the Emergency room (ER) in the last five years, bronchiolitis evolution in these patients and develop a treatment protocol for bronchiolitis patients. Methods: Longitudinal retrospective study including children diagnosed with bronchiolitis in the ER from January 1, 2014 to December 31, 2018. Patients were compared for age, month of year in which they sought the ER, clinical characteristics before and after initial approach, need for ventilatory assistance, and outcome. Results: We analyzed 614 children; 58.3% were male; mean age was 5.21 months; there was a concentration of cases between April and July; Complication was described in 18.24% of patients. First therapeutic choice was inhaled bronchodilator (60.6%). All treatments were related to a statistically significant reduction in wheezing. Treatments that showed the highest improvement rates in infant respiratory pattern were nasal washing with SF0.9% and oxygen therapy. Conclusion: Evolution in bronchiolitis patients mainly depends on how the organism reacts to infection. No treatment demonstrated efficacy in changing bronchiolitis outcome, although transitory clinical improvement. Drug usage seems to be associated with greater physician concern due to greater severity in these children. Thus, a protocol needs to be created for treating a patient with bronchiolitis which reduces unnecessary interventions.