M Verstraete1, P Cros2, M Gouin3, H Oillic3, T Bihouée3, H Denoual2, A Barzic2, A-L Duigou2, B Vrignaud4, K Levieux4, N Vabres3, E Fleurence5, E Darviot6, J Cardona7, M-A Guitteny8, Y Marot8, G Picherot3, C Gras-Le Guen9. 1. Service de pédiatrie générale, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France. Electronic address: marie.verstraete@chu-nantes.fr. 2. Service de pédiatrie générale, hôpital Morvan, CHU de Brest, 5, avenue Foch, 29609 Brest, France. 3. Service de pédiatrie générale, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France. 4. Service des urgences pédiatriques, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France. 5. Établissement de santé pour enfants et adolescents de la région nantaise (ESEAN), 58, rue des Bourdonnières, 44200 Nantes, France. 6. Service des urgences pédiatriques, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France. 7. Service des urgences pédiatriques, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France. 8. Service des urgences pédiatriques, hôpital Clocheville, CHU de Tours, 49, boulevard Béranger, 37000 Tours, France. 9. Service de pédiatrie générale, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France; Service de pédiatrie générale, hôpital Morvan, CHU de Brest, 5, avenue Foch, 29609 Brest, France; Service des urgences pédiatriques, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
Abstract
BACKGROUND AND OBJECTIVES: While our European and North American colleagues have recently updated their recommendations, the 2000 Consensus Conference remains the main guideline on management of acute viral bronchiolitis in France. We aimed to establish an updated inter-regional protocol on management of acute viral bronchiolitis in infants. METHOD: Pediatricians, pediatric pulmonologists, and emergency physicians of the Grand Ouest University Hospitals (France) gathered to analyze the recent data from the literature. RESULTS: Criteria to distinguish childhood asthma from acute viral bronchiolitis were established, then prescriptions of diagnostic tests, antibiotics, and chest physiotherapy were defined and reserved for very limited situations. Similarly, the modalities of oxygen therapy prescription and nutritional support were proposed. Finally, other therapeutics such as nebulized hypertonic saline seem promising, but their place in the treatment of acute bronchiolitis in infants remains unclear. CONCLUSION: This work has provided new proposals for management of acute viral bronchiolitis and helped standardize practices within the Grand Ouest University Hospitals. This local organization could lay the keystone for working toward guidelines initiated by learned societies at the national level.
BACKGROUND AND OBJECTIVES: While our European and North American colleagues have recently updated their recommendations, the 2000 Consensus Conference remains the main guideline on management of acute viral bronchiolitis in France. We aimed to establish an updated inter-regional protocol on management of acute viral bronchiolitis in infants. METHOD: Pediatricians, pediatric pulmonologists, and emergency physicians of the Grand Ouest University Hospitals (France) gathered to analyze the recent data from the literature. RESULTS: Criteria to distinguish childhood asthma from acute viral bronchiolitis were established, then prescriptions of diagnostic tests, antibiotics, and chest physiotherapy were defined and reserved for very limited situations. Similarly, the modalities of oxygen therapy prescription and nutritional support were proposed. Finally, other therapeutics such as nebulized hypertonic saline seem promising, but their place in the treatment of acute bronchiolitis in infants remains unclear. CONCLUSION: This work has provided new proposals for management of acute viral bronchiolitis and helped standardize practices within the Grand Ouest University Hospitals. This local organization could lay the keystone for working toward guidelines initiated by learned societies at the national level.
Authors: Antonella Di Caprio; Elena Coccolini; Paola Zagni; Eleonora Vaccina; Laura Lucaccioni; Licia Lugli; Lorenzo Iughetti; Alberto Berardi Journal: Acta Biomed Date: 2021-04-30