Akademik Veri Yönetim Sistemi
JOURNAL OF PEDIATRIC INFECTION, cilt.3, ss.61-64, 2009 (ESCI)
Bronchiolitis is a potentially life-threatening respiratory condition and the commonest reason for hospital admission in infancy. Up to 3% of all children in their first year of life are hospitalized with bronchiolitis. The respiratory syncytial virus accounts for most cases of bronchiolitis, however, new virus isolation techniques have led to the discovery of previously unrecognized viruses, including the human metapneumovirus. Bronchiolitis is associated with significant morbidity among healthy young children. Infants with underlying medical conditions, such as immunodeficiency, bronchopulmonary dysplasia and congenital heart disease, are at risk of severe progress and death. Diagnosis of acute bronchiolitis based on history and clinical findings. Diagnostic interventions have little effect on clinical outcome including routine viral tests. Supportive therapy (hydration and oxygenization) remains the mainstay of management with limited or no evidence of benefit for most other pharmacological treatments including bronchodilatators, corticosteroids, and rasemic epinephrine. Further, larger, high quality randomized controlled clinical studies are needed to clarify assessment of disease severity, criteria for hospital admission, and therapeutic options. Prevention of severe RSV-associated bronchiolitis has been achieved in high-risk infants by passive administration of the humanized monoclonal antiRSV-F antibody, palivizumab. Recent studies showed potential efficacy of palivizumab prophylaxis in infants which was born at <= 32 weeks and required mechanical ventilation as well as children with congenital heart disease. Development of more potent anti-RSV neutralizing antibodies like motavizumab, is underway, and vaccine development continues to progress