SOVREMENNAYA PEDIATRIYA.2018.2(90):81-87; doi 10.15574/SP.2018.90.81

Gonchar M. O., Muratov G. R., Logvinova O. L., Bashkirova N. V.
Kharkiv Medical University, Kharkiv, Ukraine
Communal Health Protection Institution «Kharkiv Oblast Children's Clinical Hospital», Kharkiv, Ukraine

The review provides modern guidelines for the diagnosis, management and prevention of an acute bronchiolitis in children aged from 1 to 23 months recommended by the American Academy of Pediatrics (ААР) and National Institutes for Health and Care Excellence (NICE). The work objective is to determine the paradigm of diagnosis and treatment of the acute bronchiolitis in children for the development of outpatient and inpatient care of children of Ukraine according to the global standards grounded on evidence-based criteria. The authors highlight the key criteria for the diagnosis of bronchiolitis in Ukraine and other countries of the world, suggest the unification of criteria for effective registration of the disease, the potential for use of the global methods of diagnosis and treatment of patients. Classification of severity and management peculiarities depending upon the severity of acute bronchiolitis in a child, the differential diagnosis of acute bronchiolitis, which is the topical issue for general practitioners, paediatricians and paediatric pulmonologists are presented in the paper. The therapy of children with the acute bronchiolitis is shown in terms of the out& and inpatient treatment and includes a step-by-step guidance on the peculiarities of awareness&raising activities with the child's parents, patient's feeding and logistics. The ineffectiveness of most drugs used in the routine management of acute bronchiolitis is substantiated in the paper according to the level of evidence. The current global monitoring of patients is presented. These recommendations should not be applied to the management of children with recurrent wheezing syndrome, bronchopulmonary dysplasia, neuromuscular diseases, cystic fibrosis and haemodynamically significant congenital heart defects, and immunodeficiency, including those with human immunodeficiency virus.
Key words: children, acute bronchiolitis, diagnosis, treatment.

References

1. Okhotnikova O.M., Sharikadze O.V. (2014). Hostryi bronkhiolit u ditei: nahalni pytannia diahnostyky i likuvannia. Suchasna pediatriia. 7(63): 53—62.

2. Pro zatverdzhennia protokoliv nadannia medychnoi dopomohy ditiam za spetsialnistiu Dytiacha pulmonolohiia. Nakaz MOZ Ukrainy №18 vid 13.01.2005. (2005). http://www.moz.gov.ua.

3. Amber K. Haynes, Prill Mila M., Iwane Marika K., Gerber Susan I. (2014). Respiratory syncytial virus activity — United States, July 2012 — January 2014. MMWR Morb Mortal Wkly Rep. 63(48): 1133—1136.

4. Barnard L.T., Zhang J. et al. (2016). The impact of respiratory disease in New Zealand: 2016 update. Asthma and Respiratory Foundation of New Zealand. http://www.asthmafoundation.org.nz/research/the-impact-of-respiratorydisease-in-new-zealand-2016-update.

5. Destino L., Weisgerber M.C., Soung P. et al. (2012). Validity of respiratory scores in bronchiolitis. Hosp Pediatr. 2 (4): 202—209.

6. Eber E., Midulla F. (2013). Рaediatric respiratory medicine. Hermes.

7. Fernandes R.M., Bialy L.M., Vandermeer B. et al. (2013). Glucocorticoids for acute viral bronchiolitis in infants and young children. Cochrane Database Syst. Rev. 16: 6.

8. Gadomski A.M., Scribani M.B. (2017) Bronchodilators for bronchiolitis. Cochrane Database Syst. Rev.17: 6.

9. Greenough A., Cox S., Alexander J. et al. (2001). Health care utilisation of infants with chronic lung disease, related to hospitalisation for RSV infection. Arch Dis Child. 85(6): 463—468.

10. Hall C.B., Weinberg G.A., Blumkin A.K. et al. (2013). Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics. 132(2): 123—126.

11. Mcnamarr D. (2017). Bronchiolitis: when to reassure and monitor, and when to refer CHILD. https://bpac.org.nz/2017/bronchiolitis.aspx.

12. Miller E.K., Gebretsadik T., Carroll K.N. et al. (2013). Viral etiologies of infant bronchiolitis, croup and upper respiratory illness during 4 consecutive years. Pediatr Infect Dis J. 32(9): 950—955.

13. National Institutes for Health and Care Excellence (NICE). Bronchiolitis in children: diagnosis and management (2015). http://www.nice.org.uk/guidance/ng9

14. Paediatric Research in Emergency Departments International Collaborative (PREDICT). Australasian bronchiolitis guideline (2017). http://www.predict.org.au/download/

15. Ricart S., Marcos M.A., Sarda M. et al. (2013). Clinical risk factors are more relevant than respiratory viruses in predicting bronchiolitis severity. Pediatr Pulmonol. 48 (5): 456—463.

16. Shawn L. Ralston, Lieberthal Allan S., Cody Meissner H., Alverson Brian K. (2014). Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics. 134: 1471—1502.

17. Simpson J., Reddington A., Craig E. et al. (2016). The determinants of health for children and young people in New Zealand. http://ourarchive.otago.ac.nz/handle/10523/6383.

18. Valerie J., King Viswanathan, Meera Clayton Bordley W. et al. (2014). Pharmacologic Treatment of Bronchiolitis in Infants and Children A Systematic Review. Arch Pediatr Adolesc Med. 158 (2): 127—137.