Clinical Practice Guidelines for the Diagnosis and Management of Bronchiolitis in Infants and Young Children: A Systematic Review

Abstract

Background: The respiratory syncytial virus (RSV) is the primary cause of bronchiolitis, an acute lower respiratory tract infection that typically affects young children. It puts a significant strain on families and healthcare systems as the primary cause of hospitalization for infants globally. Age affects the clinical presentation, and a number of risk factors, such as prematurity, underlying comorbidities, and environmental exposures, affect the severity.

Objective: The objective of this systematic review is to compile and assess the current Clinical Practice Guidelines (CPGs) for the diagnosis and treatment of bronchiolitis in infants and young children.

Methods: In order to better understand diagnosis, risk assessment, and treatment approaches including supportive and pharmaceutical interventions a review of published guidelines and literature was carried out.

Results: Clinical diagnosis without routine investigations is recommended by the majority of guidelines. The cornerstones continue to be nutrition, oxygen, fluids, and supportive care; there is little evidence to support the use of pharmaceutical treatments. For severe cases, non-invasive ventilation is being used more and more, though supporting data is still being gathered. Hospitalization requirements and oxygen thresholds vary.

Conclusion: Guidelines consistently discourage routine pharmacologic use while supporting supportive management and clinical diagnosis. Variations in advanced respiratory support and oxygen therapy thresholds underscore the need for more high-quality trials and standardized procedures.