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    Bronchiolitis

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    Rizky Darmawan
    Here are the key differences between pneumonia and bronchiolitis: - Pneumonia affects the alveoli (air sacs) in the lungs, while bronchiolitis primarily affects the smaller airways (bronchioles). - Pneumonia often causes a cough that produces sputum or pus, while bronchiolitis typically causes a cough without sputum. - Signs of pneumonia include fever, cough, shortness of breath, and chest pain. Bronchiolitis most commonly causes cough, wheezing, rapid or difficult breathing. - On a chest x-ray, pneumonia shows cloudy areas (infiltrates) in the lungs. A chest x-ray is

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    Bronchiolitis

    Uploaded by

    Rizky Darmawan
    171 views17 pages
    Here are the key differences between pneumonia and bronchiolitis: - Pneumonia affects the alveoli (air sacs) in the lungs, while bronchiolitis primarily affects the smaller airways (bronchioles). - Pneumonia often causes a cough that produces sputum or pus, while bronchiolitis typically causes a cough without sputum. - Signs of pneumonia include fever, cough, shortness of breath, and chest pain. Bronchiolitis most commonly causes cough, wheezing, rapid or difficult breathing. - On a chest x-ray, pneumonia shows cloudy areas (infiltrates) in the lungs. A chest x-ray is

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    Here are the key differences between pneumonia and bronchiolitis: - Pneumonia affects the alveoli (air sacs) in the lungs, while bronchiolitis primarily affects the smaller airways (bronchioles). - Pneumonia often causes a cough that produces sputum or pus, while bronchiolitis typically causes a cough without sputum. - Signs of pneumonia include fever, cough, shortness of breath, and chest pain. Bronchiolitis most commonly causes cough, wheezing, rapid or difficult breathing. - On a chest x-ray, pneumonia shows cloudy areas (infiltrates) in the lungs. A chest x-ray is

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    171 views17 pages

    Bronchiolitis

    Uploaded by

    Rizky Darmawan
    Here are the key differences between pneumonia and bronchiolitis: - Pneumonia affects the alveoli (air sacs) in the lungs, while bronchiolitis primarily affects the smaller airways (bronchioles). - Pneumonia often causes a cough that produces sputum or pus, while bronchiolitis typically causes a cough without sputum. - Signs of pneumonia include fever, cough, shortness of breath, and chest pain. Bronchiolitis most commonly causes cough, wheezing, rapid or difficult breathing. - On a chest x-ray, pneumonia shows cloudy areas (infiltrates) in the lungs. A chest x-ray is

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    BRONCHIOLITIS IN

    CHILDREN
    Ayu Setyorini MM
    DEFINITION
    Bronchiolitis is
    inflammation of
    bronchioles

    No hyaline cartilage
    rely on elastic fibre to
    maintain the patency
    obstruct easily

    Diameter 0.3 5 mm
    small obstruction
    caused significant
    symptoms

    Spread until 16th


    subdivision of
    respiratory tract
    EPIDEMIOLOGY

    2 8 12 24
    m.o m.o m.o m.o

    75% 25%

    WHY ??
    Smaller, more easily obstructed airways
    Decreased ability to clear secretions
    Insufficient collateral ventilation
    RISK FACTORS FOR SERIOUS
    ILLNESS
    Prematurity: Alveolarization occurs at ~36
    weeks gestation, and mature surfactant
    production by type II pneumocytes begins at
    34-35 weeks. Premature infants are therefore
    born with immature lungs that are unprepared
    for normal gas exchange, and are at risk for
    developing to more serious respiratory
    infections
    Congenital heart disease: significant CHDs that
    have associated pulmonary overcirculation
    pulmonary edema or pulmonary hypertension
    more severe respiratory symptoms
    Airway abnormalities: Laryngomalacia,
    tracheomalacia, and cleft lip or palate may
    have difficulty managing increased upper
    airway secretions
    Down syndrome: due to CHD (present in
    ~50% of children with DS), pulmonary
    hypertension (found in 10% who do not have
    CHD), abnormal upper airway physiology
    contributing to apnea and difficulty clearing
    secretions, and immune response alterations
    (abnormal thymus development and function,
    low B and T cell numbers)
    PATHOPHYSIOLOGY
    AGENT HOST ENVIRONMEN
    T
    RSV, RV, IV,
    HMV, AV
    INOCULATION OF
    RESPIRATORY TRACT Acute
    Prodo
    cours
    UPPER r-me
    LOWER e LOWER
    RESPIRATORY RESPIRATORY RESPIRATORY
    TRACT (Nasal) 1-2 TRACT 1d TRACT
    Copious rhinorhea d Cough, OBSTRUCTION
    tachypneu, Peribronchial
    lethargy, poor edema
    feeding, Mononuclear
    COMPLETE dehydration infiltrate
    DYNAMIC
    V:Q MISMATCH
    AIRWAY Wheezing
    AIRWAY
    Hypoxemia
    OBSTRUCTION Hypercarbia OBSTRUCTION
    Atelectasis Tachypnea Hyperinflation,
    wheezing, work
    of breathing

    RESOLUTION
    (1-2 wk)
    CLINICAL
    MANIFESTATION
    Upper respiratory tract manifestation
    day : rhinorea, coughing, subfebril
    fever
    1-2 days

    Lower respiratory tract manifestation:


    Tachypne, retraction, wheezing, coarse
    rhales
    More severe respiratory distress : nasal
    flaring, head nodding, grunting, cyanosis
    DIAGNOSIS
    Clinical basis: thorough history
    taking and physical examination

    Diagnostic testing is
    controversial but is typically
    used to exclude other diagnoses
    (eg, bacterial pneumonia, sepsis,
    or congestive heart failure) or if
    developed tendency of
    respiratory failure
    Commonly used tests in the evaluation of patients
    with bronchiolitis include the following:
    White blood cell count with differential
    Pulse oximetry
    Arterial blood gas analysis in severe respiratory distress
    Reactive protein level & blood cultures in concomittant
    sepsis
    Urine analysis, specific gravity, and culture in
    concomitant UTI
    Rapid viral antigen or nucleic acid amplification testing of
    nasopharyngeal secretions for respiratory syncytial virus
    Cerebrospinal fluid analysis and culture in seizzure
    Electrocardiography or echocardiography in arrhythmias
    or cardiomegaly
    Imaging studies
    Not routinely done
    Indication :
    Appear ill
    Clinical deteriorating
    High risk
    Atelectasis

    Hyperaerated

    Normal Bronchiolit
    thorax is
    TREATMENT
    Mainly supportive: hydration and
    oxygenation
    Hydration:
    Intravenous fluids to correct & maintain hydration
    Oral rehydration with Pedialyte, if the child want
    to drink, caution in significant work of breathing
    due to aspiration risk
    Nasogastric feeding if necessary
    Oxygen: maintain saturation >90-92%,
    delivered by an appropriate method (ex.
    nasal prongs, rebreathing or nonrebreathing
    masks)
    Bronchodilators (salbutamol 0,1 mg/kgBW mixed with
    NaCl3% @ 6 h)
    Corticosteroids (dexamethason 0,33 mg/kgBW @ 8 h)
    Antibacterial agents (ampicillin 25 mg/kgBW @ 6 h)
    Chest physiotherapy
    Nasal suction
    Mucolytic

    Are continue to be used, but none have demonstrated


    significant impact on duration of illness, severity, or
    subsequent clinical outcomes (e.g. postbronchiolitis
    wheezing)
    Some sources suggest a trial of these therapies, with
    discontinuation in the absence of effect
    Predictable course of
    bronchiolitis, the day of illness
    can guide changes to supportive
    care: a child on Day 4 who
    continues to have intermittent
    desaturation on pulse oximetry
    may not require continued
    oxygen therapy (as a child on
    Day 2 with the same clinical
    picture might)
    COMPLICATION

    ARDS
    Bronchiolitis obliterans
    Congestive heart failure
    Secondary infection
    Myocarditis
    Arrhythmias
    Chronic lung disease
    THANK YOU
    How to differentiate between
    pneumonia and bronchiolitis?

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