Bronchiolitis in the Hospitalized Patient (S4 Ep. 32)

The 2014 AAP guidelines on the treatment of bronchiolitis are a provider's medical decision-making compass, but how can we interpret the vague or absent recommendations involving advanced care of patients requiring hospitalization? This episode covers the recent evidence published since the 2014 guidelines and helps to provide some direction on key issues for patients in need of greater respiratory support.   References: Coletti, KD, Bagdure DN, Walker LK, Remy KE, Custer JW. High flow nasal cannula utilization in pediatric critical care: an observational study. Respir Care 2017;62(8):1023-1029. Elliott, S.A., Gaudet, L.A., Fernandes, R.M., Vandermeer, B., Freedman, S.B., Johnson, D.W., &… Hartling, L. (2021) Comparative efficacy of bronchiolitis interventions in acute care: A network meta-analysis. Pediatrics, 147(5), e2020040816. doi: 10.1542/peds.2020-040816. Kalburgi, S., & Halley, T. (2020). High-flow nasal cannula use outside of the ICU setting. Pediatrics, 146(5), e20194083. doi: 10.1542/peds.2019-4083. Leyenaar, J.K., & Ralston, S.L. (2020). Widespread adoption of low-value therapy: The case of bronchiolitis and high-flow oxygen. Pediatrics, 146(5), e2020021188. doi: 10.1542/peds.2020-021188. Mahant, S., Wahi, G., Bayliss, A., Giglia, L., Kanani, R., Pound, C.M., & … Canadian Paediatric Inpatient Research Network (PIRN). (2021). Intermittent vs continuous pulse oximetry in hospitalized infants with stabilized bronchiolitis: A randomized clinical trial. JAMA Pediatrics, 175(5), p. 466-474. doi: 10.1001/jamapediatrics.2020.6141. Mallory, M.D., Shay, D.K., Garrett, J., & Bordley, W.C. (2003) Bronchiolitis management preferences and the influence of pulse oximetry and respiratory rate on the decision to admit. Pediatrics, 111(1), e45-51. doi: 10.1542/peds.111.1.e45.