Bronchiolitis is an acute infection of the bronchioles as a whole is characterized by inflammatory obstruction in small airways. Bronchiolitis describes a clinical syndrome characterized by rapid breathing, chest wall retraction and respiratory sounds of wheezing sounds.
The most common cause (50-90%) were respiratory syncytial virus (RSV). A small part is caused by the influenza virus, influenza virus, adenovirus, rhinovirus, mycoplasma pneumoniae (Eaton agent).
The incidence of this disease occurred in the first 2 years of life with peak incidence at approximately age 6 months. Often occurs in winter and early spring (in countries with four seasons). The highest morbidity was found in the day care about 95%.
Bronchiolitis is usually preceded by upper respiratory tract infection accompanied by a cough, runny nose for several days, usually without fever or fever just subfebril.
Then in a few days gained more and more intense coughing, breathing frequency increased (shortness of breath), breathing shallow and fast, with nostrils breathing Intercostal and suprasternal retractions, fussy until restlessness, cyanosis, and difficulty eating or drinking.
On examination found wheezing, expiratory time prolonged, if severe obstruction barely audible breath sounds, fine crackles loud wet, sometimes heard at the end or beginning of expiration.
Patients with bronchiolitis need hospital treatment because of the onset of clinical symptoms generally require supportive care. This treatment is an emergency that needs to be handled quickly and appropriately, namely:
• The provision of oxygen to overcome hypoxemia, apnea, and respiratory failure then given oxygen 1-2 liters / minute.
• Regulating body temperature.
• Withdrawal of a sticky slime or mucus with a suction suction.
• The accuracy of intravenous fluid administration, as the avoidance of dehydration resulting from tachypnea or respiratory acidosis. Neonatal give dextrose 10%: 0.9% = 4: 1 (1-2 mEq KCl / kg BW / day) and in Infants> 1 month to give dextrose 10%: 0.9% = 3: 1 (KCl mEq/500 10 ml of fluid).
tilt or neck extension position
• Position comfortable sitting position with 30-40
Once the patient is stable, it can be done according to the cause and eliminate the handling of clinical symptoms.
Handling is as follows:
1. Corticosteroids (still controversial). Research on the use of corticosteroids, initially gave good results on morbidity and mortality with bronchiolitis. Although the recent clinical results obtained it increasingly become heavy. As a palliative therapy and anti inflamation effects, corticosteroids may lead to the masking effect.
2. Antibiotics are given if the suspect bacterial infection and should be selected that have a broad spectrum. When suspected mycoplasma pneumoniae as a cause, a drug that is selected erythromycin.
3. Giving anti-virus such as ribavirin showed satisfactory results, as ribavirin inhibits viral protein synthesis. But until now the use of anti-virus has not been given to the patient. Indications of this treatment is a high risk infants, diplasia bronkopulmonar, chronic lung infections, immunological deficiency, and congenital heart disease.
Sedativa drug is contraindicated in bronchiolitis disease because it can cause respiratory depression and is also not advisable to give bronchodilators because it can aggravate the situation of children is to increase cardiac output and child anxiety.
