Nitin Kapur
Associate Professor, University of Queensland, Australia
Title: Bronchiolitis: Can we stop the wheeze!
Biography
Biography: Nitin Kapur
Abstract
Acute viral bronchiolitis is associated with lower respiratory tract infections in infants. Although generally self-limiting and managed in the community, acute viral bronchiolitis is the most common cause of hospital admission in infants younger than 12 months of age, and is associated with substantial morbidity and health-care costs. Admissions of infants to hospital for bronchiolitis have increased in the past 20 years for reasons that might be multifactorial, although the use of pulse oximeters and insufficient evidence and clarity about levels of tolerable hypoxaemia are thought to be associated with increased admission rates.
Additionally, duration of hospital stay seems to be determined by the requirement for oxygen supplementation, even when feeding problems have resolved. National guidelines in the USA and UK differ in their recommendations for supplemental oxygen to target acceptable saturations (SpOâ‚‚) of 90% or higher, or 94% or higher, respectively. An observational study in bronchiolitis previously suggested that length of stay could be reduced when lower oxygen cut-offs were chosen, setting the stage for the randomised BIDS trial now reported by Steve Cunningham and colleagues in The Lancet, which provides welcome evidence about the use of supplemental oxygen and oxygen saturation targets in bronchiolitis. I have championed for this recommendation to be included in the EVOLVE Paediatric Thoracic Guidelines. My presentation would also discuss the latest treatment options in infants with bronchiolitis and the evidence around it, specifically touching on the three controversial aspects of it: Nebulized Hypertonic saline, supplementary oxygen and High Flow nasal cannula oxygen.