Abstract：
Bronchiolitis is an acute respiratory illness that is the leading cause of hospitalization in young children. This document aims to update the consensus document published in 2014 to provide guidance on the current best practices for managing bronchiolitis in infants. The document addresses care in both hospitals and primary care. The diagnosis of bronchiolitis is based on the clinical history and physical examination. The mainstays of management are largely supportive, consisting of fluid management and respiratory support. Evidence suggests no benefit with the use of salbutamol, glucocorticosteroids and antibiotics with potential risk of harm. Because of the lack of effective treatment, the reduction of morbidity must rely on preventive measures. De-implementation of non-evidence-based interventions is a major goal, and educational interventions for clinicians should be carried out to promote high-value care of infants with bronchiolitis. Well-prepared implementation strategies to standardize care and improve the quality of care are needed to promote adherence to guidelines and discourage non-evidence-based attitudes. In parallel, parents\' education will help reduce patient pressure and contribute to inappropriate prescriptions. Infants with pre-existing risk factors (i.e., prematurity, bronchopulmonary dysplasia, congenital heart diseases, immunodeficiency, neuromuscular diseases, cystic fibrosis, Down syndrome) present a significant risk of severe bronchiolitis and should be carefully assessed. This revised document, based on international and national scientific evidence, reinforces the current recommendations and integrates the recent advances for optimal care and prevention of acute bronchiolitis.
摘要：
细支气管炎是一种急性呼吸道疾病，是幼儿住院的主要原因。本文件旨在更新2014年发布的共识文件，为当前管理婴儿细支气管炎的最佳实践提供指导。该文件涉及医院和初级保健的护理。毛细支气管炎的诊断基于临床病史和体格检查。管理层的中流砥柱在很大程度上是支持的，包括液体管理和呼吸支持。证据表明使用沙丁胺醇没有益处，糖皮质激素和抗生素具有潜在的危害风险。由于缺乏有效的治疗,降低发病率必须依靠预防措施。取消基于证据的干预措施是一个主要目标，并对临床医生进行教育干预，以促进毛细支气管炎婴儿的高价值护理。需要精心准备的实施策略来标准化护理和提高护理质量，以促进对指南的遵守并阻止非循证态度。并行,父母的教育将有助于减轻患者的压力，并有助于不适当的处方。具有预先存在的风险因素的婴儿(即，早产,支气管肺发育不良,先天性心脏病,免疫缺陷,神经肌肉疾病,囊性纤维化,唐氏综合征）存在严重细支气管炎的重大风险，应仔细评估。本修订文件,基于国际和国家科学证据，加强了目前的建议,并整合了最近在急性细支气管炎的最佳治疗和预防方面的进展.
