Bronchiolitis is a clinical picture that occurs with the obstruction of the bronchioles, the smallest airways of the lungs, as a result of viral infection. It occurs especially in children under two years of age. This picture caused by viruses occurs frequently in winter and spring.
They are stimulated by bronchiolar viruses, which are the smallest part of the lungs, and cause edema in this area. As a result of this edema, mucous plugs form in the bronchioles. These plugs formed in babies with small bronchioles cause airway obstruction and cause serious pictures.
Viruses cause bronchiolitis.
- Respiratory Syncytial Virus (RSV)
- Parainfluenza viruses and mycoplasma cause bronchiolitis. The main cause of bronchiolitis is the respiratory syncytial virus (RSV). RSV progresses in the form of epidemics in the spring and winter months. Especially in rainy seasons, outbreaks become apparent.
Most of the population will encounter the RSV virus up to the age of three. Generally, the first RSV infection is severe, and recurrent infections are mild. When children are older than two years of age encounter RSV, bronchiolitis does not occur, respiratory tract disease is seen. Bronchiolitis develops as a result of exposure to RSV in a child younger than two years old.
What are the symptoms of bronchiolitis?
- The first symptoms are a runny nose
- It is a lack of appetite.
The infection picture progresses and, in addition to upper respiratory tract symptoms, bronchioles involvement
- Increased respiratory rate
- Wheezing breathing
- Persistent cough
- Nutritional difficulties occur.
Breathing cessation (apnea) may develop in babies younger than two months and premature babies. In severe cases, the participation of the nasal wings in breathing adds to the difficult breathing picture. A decrease in oxygen level (hypoxia) and bruising (cyanosis) may develop. Fever may not be seen in all cases of bronchiolitis.
Bronchiolitis diagnosis: It is made according to history and physical examination findings. Blood tests and chest radiography have no place in diagnosis. Unnecessary laboratory examinations should not be done. The definitive diagnosis is made by isolating viruses from respiratory tract secretions.
In a patient with bronchiolitis;
- Difficulty breathing
- Bruising of the skin
- Dark yellow and green nasal discharge
- A decrease in the amount of urine
- Dry mouth
- If there are signs of tear reduction and the baby is less than 2-3 months old, urgent intervention is required.
Acute bronchiolitis treatment is supportive treatment.
It should be ensured that the patient is relieved of respiratory distress, regulation of hydration, and prevention of complications.
We see that the drugs used in the treatment of bronchiolitis for many years are not recommended for treatment today. (American children’s academy, 2014)
In children younger than two years old;
- The salbutamol treatment was discontinued as it seemed that the effect was not sufficient.
- Epinephrine therapy is not recommended.
- There is no place for corticosteroid therapy.
- Antibiotic treatment is not applied. If the bacterial factor is considered together with viral reason, it can only be given then.
- Intravenous fluids can be given to patients who are not well hydrated and cannot take orally.
- Breastfeeding babies
- Stay away from the smoking environment
- Frequent hand washing and use of masks should be ensured when necessary.
- In high-risk babies, RSV monoclonal antibody (palivizumab) 15 mg/kg can be given in the first year to be administered for a maximum of 5 months.
Bronchiolitis usually resolves within two to five days. It is seen that wheezing continues in some children. This process may be prolonged in premature babies and babies with lung and heart disease. Most of the time, RSV bronchiolitis presents with recurrent wheezing attacks. Findings related to bronchiolitis in infancy may continue for years. The possibility of asthma is high in children who had bronchitis in infancy.
BRONCHIOLITE IS A CLINICAL DIAGNOSIS.
- LUNG GRAPHICS AND BLOOD EXAMINATIONS DO NOT HAVE A PLACE IN DIAGNOSIS.
- CAUSE OF BRONCHIOLITE VIRUSES IS A CLINICAL TABLE.
- ANTIBIOTICS ARE NOT GIVEN IN THE TREATMENT. RESPIRATORY RELAXATION TREATMENT IS NOT RECOMMENDED.
- THE BRONCHIOLITE – ASTMA RELATIONSHIP SHOULD NOT BE FORGOTTEN.
- Viral Infections