Management of bronchiolitis: current practices in Ireland

Ir Med J. 2002 Jun;95(6):167-9.

Abstract

To establish current practice for hospital-based treatment of uncomplicated respiratory syncytial virus (RSV) infection in the Republic of Ireland. A questionnaire was sent to all consultant general paediatricians in the Republic of Ireland. The questionnaire described a clinical scenario and this was followed by a list of management questions. The scenario was of a 3-month-old infant with uncomplicated but moderately severe RSV infection requiring hospitalization. Seventy-three questionnaires were sent. 63/73 (86%) of the questionnaires were returned. With respect to management of this case almost all (61/63) the paediatricians felt that oxygen therapy was necessary (oxygen saturation described in the case was 90%). With respect to bronchodilator therapy, ipratropium bromide (38/63--60%) was chosen much more frequently than salbutamol (15/63--24%). Chest physiotherapy would have been prescribed by 8/63--13% of paediatricians. Oral steroids were infrequently chosen (1/63--2%) but nebulised steroids were selected in 7/63 (11%) cases. The routine use of RSV monoclonal antibody, palivizumab, for RSV prophylaxis was reported by 49% (31/63) of paediatricians. Prematurity with bronchopulmonary dysplasia was considered an indication for its administration by all of these but only 23% considered prematurity alone to be an indication. The management of infants with RSV bronchiolitis varies greatly among consultant paediatricians in Ireland. Evidence based guidelines may be of value in establishing a more uniform national treatment approach.

MeSH terms

  • Albuterol / therapeutic use
  • Anti-Inflammatory Agents / administration & dosage
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents / administration & dosage
  • Bronchiolitis / therapy*
  • Bronchiolitis / virology
  • Bronchodilator Agents / therapeutic use
  • Epinephrine / administration & dosage
  • Evidence-Based Medicine
  • Humans
  • Infant
  • Ipratropium / therapeutic use
  • Ireland
  • Oxygen Inhalation Therapy
  • Palivizumab
  • Pediatrics*
  • Physical Therapy Specialty
  • Physicians*
  • Respiratory Syncytial Virus Infections
  • Respiratory Syncytial Viruses
  • Steroids
  • Surveys and Questionnaires*

Substances

  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents
  • Bronchodilator Agents
  • Steroids
  • Palivizumab
  • Ipratropium
  • Albuterol
  • Epinephrine