Pediatrics
Baby 3 months old with bronchiolitis symptoms and poor feeding.
O2 89%. What is the management?
الشرح
Core Concept: Acute bronchiolitis is a viral lower respiratory tract infection (most commonly RSV) causing inflammation and mucus plugging in the small airways of infants.
Clinical Presentation:
- Rhinorrhea, cough, tachypnea, wheezing, retractions, and poor feeding due to respiratory distress.
Diagnosis:
- First-line: Clinical diagnosis.
- Gold Standard: Clinical assessment of work of breathing and hydration status; viral testing is optional.
Management:
- Acute: Supportive care is the mainstay. For an infant with hypoxia (SpO2 89%) and poor feeding, the appropriate management is low flow oxygen to maintain SpO2 > 90%, feeding support (via NGT or IV fluids if oral feeding is unsafe), and nasal suctioning to clear upper airway secretions.
- Long-term: Bronchodilators and corticosteroids are not routinely recommended.