BRONQUIOLITIS EN PEDIATRIA PUESTA AL DIA PDF

Please, help me to find this ingreso hospitalario por bronquiolitis pdf. I’ll be really very grateful. Bronquiolitis en pediatría: puesta al día. Article (PDF Available) in Pediatria de Atencion Primaria 15(58) · April bServicio de Pediatría, .. Pérez P. Bronquiolitis en pediatría: puesta al día. Inf. Puesta al día para el médico pediatra / terística destacable de estas dos . resistiva: obstrucción de la vía aérea superior, broncoespasmo, bronquiolitis.

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Rev Pediatr Aten Primaria. The patients who received 0. The days of hospitalization and the hours of oxygen therapy were used as the result measurement.

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In the group receiving FSS the average stay in hospital was 5. There was no significant difference between the groups. Acute bronchiolitis AB is the most common lower respiratory tract infection in children younger than a year, with the youngest infants requiring hospitalisation most frequently and being subjected to therapeutic interventions and diagnostic tests whose efficacy and usefulness are not sufficiently proven 1.

AB may be one of the most widely studied pathologies in children, with numerous clinical practice guidelines and expert group recommendations addressing the condition 23yet despite all the published information there is no consensus on how to provide treatment for this group of patients. The lag between clinical practise and scientific evidence leads to a high and unjustified use of social and economic resources 45. AB is characterised by an acute inflammation of the terminal bronchioles, with airway oedema and mucus plugging being the predominant pathological features, which is why any therapeutic approach that can decrease these alterations and improve secretion clearance can be beneficial 6.

Hypertonic saline solutions HSS are composed of sodium chloride dissolved in distilled water. Thus far, oxygen therapy is the only treatment that has been shown to improve the clinical course of AB, which is why the management of these patients is based on general supportive care measures 8.

ingreso hospitalario por bronquiolitis pdf

We did not perform sample size calculations because we considered that the number of admissions with an AB diagnosis in the selected period was within the expected range, and also due pedistria the unpredictability of the incidence of puestx disease. Children were diagnosed with AB if they had a history of preceding viral upper respiratory tract infection and a clinical presentation with respiratory distress and wheezing or crackles on chest auscultation McConnochie criteria.

The children that presented at least one of the following symptoms during the emergency room visit were admitted pediatrai the hospital: We excluded from the study children with chronic respiratory problems or cardiopathies, and those children who presented with critical AB illness requiring admission to the intensive care unit. The treatment consisted of administering 3 cc of saline solution with a standard nebulizer along with oxygen every eight hours if this was the sole treatment, and every four to six hours if it was phesta in combination with drugs.

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The outcome measures used in this study were the duration of the hospital stay in days and the hours of oxygen therapy received. Oxygen saturation levels were recorded by the nursing staff every four hours. The criteria for discharge were not having a fever, a good general health status, tolerating oral feeding, and not requiring oxygen therapy. We expressed the basic data in means and standard deviations for quantitative variables, and in frequencies and percentages in the case of qualitative variables.

We used the Mann-Whitney U test for comparing quantitative variables after finding that they did not fit a normal distribution Kolmogorov-Smirnov test. The comparison of qualitative variables was done using the chi-squared test. We considered the results statistically significant for p values below 0. The total number of patients admitted with an AB diagnosis and younger than seven months during the, and seasons included in this study wasof whom The age range of the patients was ten days to 6.

Table 1 shows the general characteristics of the patients and the comparisons between the two groups according to the treatment they received, and we saw that there were no significant differences between them. Table 3 shows the results obtained bronqujolitis relation to the presence or absence peeiatria respiratory syncytial virus RSV in the nasopharyngeal aspirates. We have known for a while that HSS increases mucociliary clearance in normal patients 9 and that its use is useful and safe as a therapeutic strategy in diseases with defective mucociliary clearance such as asthma, bronchiectasis, and cystic fibrosis The potential beneficial effects of hypertonic saline solution may be due to its theoretical ability to lower the viscosity and elasticity of the mucous gel: The literature we reviewed included studies done with hospitalised patients and studies with patients that sought emergency room care but were not admitted to the hospital.

The outcome measures selected in each case were different, and consequently the results obtained from hospitalised patients cannot be extrapolated to outpatient services and vice versa, which means that there is a setting-related bias that, of course, is also present in our study.

When it comes to the duration of hospital stays, the average length of hospitalisation due to AB in the literature is pdeiatria 3 to 5 days, and our results conform to the literature on this point with a mean of 4.

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The Cochrane review that we consulted 13 included three hospital studies in which the authors presented statistically significant results, with a 0.

The Cochrane review itself has been the subject of critical evaluation by other authorsas establishing the therapeutic function of HSS has significant clinical implications. In their studies, Luo Z, et al. The children included aal this study required oxygen therapy during their hospital stay, and the hours of therapy required were another outcome measure. We found bronuqiolitis the need for oxygen therapy was significantly reduced in the group of children younger than 3 months who were given nebulised PSS; furthermore, the children whose nasopharyngeal aspirates tested positive for RSV and who were given nebulised PSS also required fewer hours of oxygen therapy.

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We bronquiolitus to emphasise that these results cannot be extrapolated to ambulatory patients, who at that level of care do not require oxygen therapy.

In the studies done with ambulatory patients, the outcome measures used to assess the efficacy of the treatment consisted in evaluating the improvement of symptoms following its application, and in quantifying the reduction in hospital admissions.

One limitation in our study was that the patients were not randomly assigned to treatment and control groups. Considering the prevalence of AB, and its social and economic repercussions, we should emphasise the need to carry out studies on this subject in the future. The authors declare that they had no conflict of interests when it came to preparing and publishing this paper.

Reference of this article.: RESULTS The total number of patients admitted with an AB diagnosis and younger than seven months during the, and seasons included in this study wasof whom Calogero C, Sly PD. To treat or not to treat. That is the question. Mandelberg A, Amirav I. Hypertonic saline or high volume normal saline for viral bronchiolitis: Inf Ter Sist Nac Salud. Inhalation of hypertonic saline aerosol enhances mucociliary clearance in asthmatic and healthy subjects.

Effect of hypertonic saline, amiloride and cough on muciciliary clearance in patients with cystic fibrosis. Rev Posgrado de la VI. Conferencia de Consenso sobre bronquiolitis aguda IV: Nebulized hypertonic saline solution for acute bronchiolitis in infants. Cochrane Database Syst Rev. Isr Med Assoc J. Nebulized hypertonic saline in the treatment of viral bronchiolitis in infants.

Horner D, Jenner R.

Nebulised hypertonic saline significantly decreases length of hospital stay and reduces symptoms in children with bronchiolitis. Hypertonic saline nebulization for bronchiolitis.

Nebulized hypertonic saline treatment in hospitalized children with moderate to severe viral bronchiolitis. Arch Pediatr Adolesc Med. Effect of inhaled hypertonic saline on hospital admission rate in children with viral bronchiolitis: Nebulized hypertonic saline without adjunctive bronchodilators for children with bronchiolitis.