Forty-Four Questions I Would Like to Ask Bronchiolitis Guideline Writers and Researchers

Authors

  • Larry B. Mellick Division Chief of Pediatric Emergency Medicine, Department of Emergency Medicine, University of South Alabama, 307 N University Blvd, Mobile, AL 36688, USA

DOI:

https://doi.org/10.17140/EMOJ-8-e007

Abstract

It is obvious that the de-implementation movement initiated by the bronchiolitis guidelines has not gone as planned. In the United States substantial elements of the bronchiolitis guidelines are generally not being followed in outpatient settings, emergency departments and pediatric intensive care units. Guideline non-compliance is also a conspicuous international problem.

References

Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical Prac-tice Guideline: The diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014; 134(5): e1474-502. doi: 10.1542/

Mellick LB, Gonzalez J. The problematic 2014 American Acade-my of Pediatrics Bronchiolitis Guidelines. Pediatr Emerg Care. 2019; 35(9): 654-658. doi: 10.1097/PEC.0000000000001915

Rivera-Sepulveda AV, Rebmann T, Gerard J, Charney RL. Physi-cian Compliance with Bronchiolitis Guidelines in Pediatric Emer-gency Departments. Clin Pediatr (Phila). 2019; 58(9): 1008-1018. doi: 10.1177/0009922819850462

Hester G, Nickel AJ, Watson D, Bergmann KR. Factors Associ-ated with Bronchiolitis Guideline Non-adherence at US Children’s Hospitals. Hosp Pediatr. 2021; 11(10): 1102-1112. doi: 10.1542/ hpeds.2020-005785

Gong C, Byczkowski T, McAneney C, Goyal MK, Florin TA. Emergency Department Management of Bronchiolitis in the Unit-ed States. Pediatr Emerg Care. 2019; 35(5): 323-329. doi: 10.1097/ PEC.0000000000001145

House SA, Marin JR, Hall M, Ralston SL. Trends over time in use of nonrecommended tests and treatments since publication of the American Academy of Pediatrics Bronchiolitis Guideline. JAMA Netw Open. 2021; 4(2): e2037356. doi: 10.1001/jamanet-workopen.2020.37356

Bradshaw ML, Déragon A, Puligandla P, Emeriaud G, Canakis AM, Fontela PS. Treatment of severe bronchiolitis: A survey of Canadian pediatric intensivists. Pediatr Pulmonol. 2018; 53(5): 613- 618. doi: 10.1002/ppul.23974

Biagi C, Scarpini S, Paleari C, et al. Impact of Guidelines publica-tion on acute bronchiolitis management: 10-year experience from a tertiary care center in Italy. Microorganisms. 2021; 9(11): 2221. doi: 10.3390/microorganisms9112221

Marcos-Morales A, García-Salido A, Leoz-Gordillo I, et al. Re-spiratory and pharmacological management in severe acute bron-chiolitis: Were clinical guidelines not written for critical care? Arch Pediatr. 2021; 28(2): 150-155. doi: 10.1016/j.arcped.2020.11.007

Fontoura-Matias J, Moreira-Sousa D, Freitas A, Azevedo I. Management of bronchiolitis in Portugal, 2000-2015: Do guide-lines have an impact? Pediatr Pulmonol. 2020; 55(1): 198-205. doi: 10.1002/ppul.24486

Buendía JA, Rodríguez CA. A predictive model of inappropri-ate use of medical tests and medications in bronchiolitis. Pan Afr Med J. 2020; 37: 94. doi: 10.11604/pamj.2020.37.94.22712

McDaniel CE, House SA, Ralston SL. Behavioral and psy-chological aspects of the physician experience with deimple-mentation. Pediatr Qual Saf. 2022; 7(1): e524. doi: 10.1097/ pq9.0000000000000524

Ralston SL, Atwood EC, Garber MD, Holmes AV. What works to reduce unnecessary care for bronchiolitis? A qualitative analysis of a national collaborative. Acad Pediatr. 2017; 17(2): 198-204. doi: 10.1016/j.acap.2016.07.001

McCoy E, Chumpia M. Decreasing racemic epinephrine for bronchiolitis in an academic Children’s Hospital. Hosp Pediatr. 2018; 8(10): 651-657. doi: 10.1542/hpeds.2017-0214

Montejo M, Paniagua N, Saiz-Hernando C, Martinez-Indart L, Mintegi S, Benito J. Initiatives to reduce treatments in bronchiol-itis in the emergency department and primary care. Arch Dis Child. 2021; 106(3): 294-300. doi: 10.1136/archdischild-2019-318085

Sprecher E, Chi G, Ozonoff A, Cox J, Patel N, Conroy K. Use of social psychology to improve Adherence to National Bronchi-olitis Guidelines. Pediatrics. 2019; 143(1): e20174156. doi: 10.1542/

Dunn M, Muthu N, Burlingame CC, et al. Reducing alb-uterol use in children with bronchiolitis. Pediatrics. 2020; 145(1): e20190306. doi: 10.1542/peds.2019-0306

Korppi M. Local healthcare professionals need to work to-gether to implement bronchiolitis guidelines that stop unnecessary tests and treatments. Acta Paediatr. 2022; 111(7): 1319-1323. doi: 10.1111/apa.16322

Colla CH, Mainor AJ, Hargreaves C, Sequist T, Morden N. Interventions aimed at reducing use of low-value health services: A systematic review. Med Care Res Rev. 2017; 74(5): 507-550. doi: 10.1177/1077558716656970

Haskell L, Tavender EJ, Wilson CL, et al. Effectiveness of tar-geted interventions on treatment of infants with bronchiolitis: A randomized clinical trial. JAMA Pediatr. 2021; 175(8): 797-806. doi: 10.1001/jamapediatrics.2021.0295

Haskell L, Tavender EJ, Wilson CL, et al. Development of targeted, theory-informed interventions to improve bronchiolitis management. BMC Health Serv Res. 2021; 21(1): 769. doi: 10.1186/ s12913-021-06724-6

Fretzayas A, Moustaki M. Etiology and clinical features of viral bronchiolitis in infancy. World J Pediatr. 2017; 13(4): 293-299. doi: 10.1007/s12519-017-0031-8

Fernandes RM, Andrade MG, Constant C, et al. Acute viral bronchiolitis: Physician perspectives on definition and clinically important outcomes. Pediatr Pulmonol. 2016; 51(7): 724-732. doi: 10.1002/ppul.23346

Hancock DG, Charles-Britton B, Dixon DL, Forsyth KD. The heterogeneity of viral bronchiolitis: A lack of universal consensus definitions. Pediatr Pulmonol. 2017; 52(9): 1234-1240. doi: 10.1002/ ppul.23750

Rodríguez-Martínez CE, Castro-Rodriguez JA, Nino G, Mi-dulla F. The impact of viral bronchiolitis phenotyping: Is it time to consider phenotype-specific responses to individualize phar-macological management? Paediatr Respir Rev. 2020; 34: 53-58. doi: 10.1016/j.prrv.2019.04.003

Douros K, Everard ML. Time to say goodbye to bronchiolitis, viral wheeze, reactive airways disease, wheeze bronchitis and all that. Front Pediatr. 2020; 8: 218. doi: 10.3389/fped.2020.00218

Megalaa R, Perez GF, Kilaikode-Cheruveettara S, Kotwal N, Rodriguez-Martinez CE, Nino G. Clinical definition of respira-tory viral infections in young children and potential bronchiolitis misclassification. J Investig Med. 2018; 66(1): 46-51. doi: 10.1136/ jim-2017-000491

Ralston SL, House SA, Harrison W, Hall M. The evolution of quality benchmarks for bronchiolitis. Pediatrics. 2021; 148(3): e2021050710. doi: 10.1542/peds.2021-050710

Lipshaw MJ, Florin TA. “Don’t just do something, stand there”: Embracing deimplementation of bronchiolitis therapeutics. Pediat-rics. 2021; 147(5): e2020048645. doi: 10.1542/peds.2020-048645

Kirolos A, Manti S, Blacow R, et al. A systematic review of clinical practice guidelines for the diagnosis and management of bronchiolitis. J Infect Dis. 2020; 222(Suppl 7): S672-S679. doi: 10.1093/infdis/jiz240

Polack FP, Stein RT, Custovic A. The syndrome we agreed to call bronchiolitis. J Infect Dis. 2019; 220(2): 184-186. doi: 10.1093/ infdis/jiz082

Dumas O, Mansbach JM, Jartti T, et al. A clustering approach to identify severe bronchiolitis profiles in children. Thorax. 2016; 71(8): 712-718. doi: 10.1136/thoraxjnl-2016-208535

Rodriguez-Martinez CE, Nino G, Castro-Rodriguez JA, Perez GF, Sossa-Briceño MP, Buendia JA. Cost-effectiveness analysis of phenotypic-guided versus guidelines-guided bronchodilator thera-py in viral bronchiolitis. Pediatr Pulmonol. 2021; 56(1): 187-195. doi: 10.1002/ppul.25114

Rodriguez-Fernandez R, Tapia LI, Yang CF, et al. Respiratory syncytial virus genotypes, host immune profiles, and disease sever-ity in young children hospitalized with bronchiolitis. J Infect Dis. 2017; 217(1): 24-34. doi: 10.1093/infdis/jix543

Cunningham S, Nair H, Campbell H. Deciphering clinical phe-notypes in acute viral lower respiratory tract infection: Bronchi-olitis is not an island. Thorax. 2016; 71(8): 679-680. doi: 10.1136/ thoraxjnl-2016-209012

Midulla F, Nenna R, Scagnolari C, et al. How respiratory syn-cytial virus genotypes influence the clinical course in infants hos-pitalized for bronchiolitis? J Infect Dis. 2019; 219(4): 526-534. doi: 10.1093/infdis/jiy496

Hasegawa K, Dumas O, Hartert TV, Camargo CA Jr. Advancing our understanding of infant bronchiolitis through phenotyping and endotyping: Clinical and molecular approaches. Expert Rev Respir Med. 2016; 10(8): 891-899. doi: 10.1080/17476348.2016.1190647

Vandini S, Biagi C, Lanari M. Respiratory syncytial virus: The influence of serotype and genotype variability on clinical course of infection. Int J Mol Sci. 2017; 18(8): 1717. doi: 10.3390/ ijms18081717

Rodríguez-Martínez CE, Nino G, Castro-Rodriguez JA, Acuña-Cordero R, Sossa-Briceño MP, Midulla F. For which infants with viral bronchiolitis could it be deemed appropriate to use albuterol, at least on a therapeutic trial basis? Allergol Immunopathol (Madr). 2021; 49(1): 153-158. doi: 10.15586/aei.v49i1.12

Kellner JD, Ohlsson A, Gadomski AM, Wang EE. Efficacy of bronchodilator therapy in bronchiolitis. A meta-analysis. Arch Pediatr Adolesc Med. 1996; 150(11): 1166-1172. doi: 10.1001/arch-pedi.1996.02170360056009

Scarlett EE, Walker S, Rovitelli A, Ren CL. Tidal breathing re-sponses to albuterol and normal saline in infants with viral bron-chiolitis. Pediatr Allergy Immunol Pulmonol. 2012; 25(4): 220-225. doi: 10.1089/ped.2012.0141

Mallol J, Barrueto L, Girardi G, et al. Use of nebulized bron-chodilators in infants under 1 year of age: Analysis of four forms of therapy. Pediatr Pulmonol. 1987; 3(5): 298-303. doi: 10.1002/ ppul.1950030504

Chavasse R, Seddon P, Bara A, McKean M. Short acting beta agonists for recurrent wheeze in children under 2 years of age. Cochrane Database Syst Rev. 2002; 2002(3): CD002873. doi: 10.1002/14651858.CD002873

Levin DL, Garg A, Hall LJ, Slogic S, Jarvis JD, Leiter JC. A pro-spective randomized controlled blinded study of three broncho-dilators in infants with respiratory syncytial virus bronchiolitis on mechanical ventilation. Pediatr Crit Care Med. 2008; 9(6): 598-604. doi: 10.1097/PCC.0b013e31818c82b4

Totapally BR, Demerci C, Zureikat G, Nolan B. Tidal breath-ing flow-volume loops in bronchiolitis in infancy: The effect of albuterol [ISRCTN47364493]. Crit Care. 2002; 6(2): 160-165. doi: 10.1186/cc1476

Alario AJ, Lewander WJ, Dennehy P, Seifer R, Mansell AL. The efficacy of nebulized metaproterenol in wheezing infants and young children. Am J Dis Child. 1992; 146(4): 412-418. doi: 10.1001/archpedi.1992.02160160032008 Editorial | Volume 8 | Number 1 | Melick LB

Walsh P, Caldwell J, McQuillan KK, Friese S, Robbins D, Rothenberg SJ. Comparison of nebulized epinephrine to alb-uterol in bronchiolitis. Acad Emerg Med. 2008; 15(4): 305-313. doi: 10.1111/j.1553-2712.2008.00064.x

Gadomski AM, Scribani MB. Bronchodilators for bronchi-olitis. Cochrane Database Syst Rev. 2014; 2014 (6): CD001266. doi: 10.1002/14651858.CD001266.pub4

King VJ, Viswanathan M, Bordley WC, et al. Pharmacologic treatment of bronchiolitis in infants and children: S systematic re-view. Arch Pediatr Adolesc Med. 2004; 158(2): 127-37. doi: 10.1001/ archpedi.158.2.127

Rodrigo GJ, Nannini LJ. Comparison between nebulized adrenaline and beta2 agonists for the treatment of acute asthma. A meta-analysis of randomized trials. Am J Emerg Med. 2006; 24(2): 217-222. doi: 10.1016/j.ajem.2005.10.008

Wiebe K, Rowe BH. Nebulized racemic epinephrine used in the treatment of severe asthmatic exacerbation: A case report and literature review. CJEM. 2007; 9(4): 304-308. doi: 10.1017/ s1481803500015220

Plint AC, Osmond MH, Klassen TP. The efficacy of nebulized racemic epinephrine in children with acute asthma: A randomized, double-blind trial. Acad Emerg Med. 2000; 7(10): 1097-1103. doi: 10.1111/j.1553-2712.2000.tb01258.x

Adoun M, Frat JP, Doré P, Rouffineau J, Godet C, Robert R. Comparison of nebulized epinephrine and terbutaline in patients with acute severe asthma: A controlled trial. J Crit Care. 2004; 19(2): 99-102. doi: 10.1016/j.jcrc.2004.04.005

Kjellman B, Tollig H, Wettrell G. Inhalation of racemic epi-nephrine in children with asthma. Dose-response relation and comparison with salbutamol. Allergy. 1980; 35(7): 605-610. doi: 10.1111/j.1398-9995.1980.tb01811.x

Pereira RA, Oliveira de Almeida V, Zambrano M, Zhang L, Amantéa SL. Effects of nebulized epinephrine in association with hypertonic saline for infants with acute bronchiolitis: A system-atic review and meta-analysis. Health Sci Rep. 2022; 5(3): e598. doi: 10.1002/hsr2.598

Hartling L, Bialy LM, Vandermeer B, et al. Epinephrine for bronchiolitis. Cochrane Database Syst Rev. 2011; (6): CD003123. doi: 10.1002/14651858.CD003123.pub3

Hartling L, Wiebe N, Russell K, Patel H, Klassen TP. Epi-nephrine for bronchiolitis. Cochrane Database Syst Rev. 2004; (1): CD003123. doi: 10.1002/14651858.CD003123.pub2

Tudor GJ, Hafner JW. In infants younger than 24 months old and with bronchiolitis, does nebulized epinephrine improve clini-cal status? Ann Emerg Med. 2013; 61(3): 289-290. doi: 10.1016/j. annemergmed.2012.09.014

Primatene Mist Prices. Coupons & Savings Tips. https://www. singlecare.com/prescription/primatene-mist. Accessed June 4, 2022.

Nephron Pharmaceuticals. Racepinephrine Inhalation Solution 2.25% Inhalation Solutions. https://www.nephronpharm.com/ products/racepinephrine-inhalation-solution-225. Accessed June 4, 2022.

Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP. Nebulised hypertonic saline solution for acute bronchiolitis in infants. Cochrane Database Syst Rev. 2017; 12(12): CD006458. doi: 10.1002/14651858.CD006458.pub4

Zhang L, Gunther CB, Franco OS, Klassen TP. Impact of hy-pertonic saline on hospitalization rate in infants with acute bron-chiolitis: A meta-analysis. Pediatr Pulmonol. 2018; 53(8): 1089-1095. doi: 10.1002/ppul.24066

Chen YJ, Lee WL, Wang CM, Chou HH. Nebulized hypertonic saline treatment reduces both rate and duration of hospitalization for acute bronchiolitis in infants: An updated meta-analysis. Pediatr Neonatol. 2014; 55(6): 431-438. doi: 10.1016/j.pedneo.2013.09.013

Elliott SA, Gaudet LA, Fernandes RM, et al. Comparative efficacy of bronchiolitis interventions in acute care: A network meta-analysis. Pediatrics. 2021; 147(5): e2020040816. doi: 10.1542/

Hsieh CW, Chen C, Su HC, Chen KH. Exploring the efficacy of using hypertonic saline for nebulizing treatment in children with bronchiolitis: A meta-analysis of randomized controlled trials. BMC Pediatr. 2020; 20(1): 434. doi: 10.1186/s12887-020-02314-3

Badgett RG, Vindhyal M, Stirnaman JT, et al. A living system-atic review of nebulized hypertonic saline for acute bronchiolitis in infants. JAMA Pediatr. 2015; 169: 788-789. doi: 10.1001/jamapedi-atrics.2015.0681

Baron J, El-Chaar G. Hypertonic saline for the treatment of bronchiolitis in infants and young children: A critical review of the Submit your article to this journal | https://openventio.org/submit-manuscript/ literature. J Pediatr Pharmacol Ther. 2016; 21: 7-26. doi: 10.5863/1551- 6776-21.1.7

Lin J, Zhang Y, Song A, Ying L, Dai J. Exploring the appro-priate dose of nebulized hypertonic saline for bronchiolitis: A dose-response meta-analysis. J Investig Med. 2022; 70(1): 46-54. doi: 10.1136/jim-2021-001947

Stobbelaar K, Kool M, de Kruijf D, et al. Nebulised hypertonic saline in children with bronchiolitis admitted to the paediatric in-tensive care unit: A retrospective study. J Paediatr Child Health. 2019; 55(9): 1125-1132. doi: 10.1111/jpc.14371

Mahant S, Parkin PC, Thavam T, et al. Rates in bronchiolitis hospitalization, intensive care unit use, mortality, and costs from 2004 to 2018. JAMA Pediatr. 2022; 176(3): 270-279. doi: 10.1001/ jamapediatrics.2021.5177

Shanahan KH, Monuteaux MC, Nagler J, Bachur RG. Early use of bronchodilators and outcomes in bronchiolitis. Pediatrics. 2021; 148(2): e2020040394. doi: 10.1542/peds.2020-040394

Linssen RS, Bem RA, Kapitein B, et al. Burden of respiratory syncytial virus bronchiolitis on the Dutch pediatric intensive care units. Eur J Pediatr. 2021; 180(10): 3141-3149. doi: 10.1007/s00431- 021-04079-y

Linssen RS, Teirlinck AC, van Boven M, et al. Increasing bur-den of viral bronchiolitis in the pediatric intensive care unit; an observational study. J Crit Care. 2022; 68: 165-168. doi: 10.1016/j. jcrc.2021.07.009

Pham H, Thompson J, Wurzel D, Duke T. Ten years of se-vere respiratory syncytial virus infections in a tertiary paediatric intensive care unit. J Paediatr Child Health. 2020; 56(1): 61-67. doi: 10.1111/jpc.14491

Goh CT, Kirby LJ, Schell DN, Egan JR. Humidified high-flow nasal cannula oxygen in bronchiolitis reduces need for invasive ventilation but not intensive care admission. J Paediatr Child Health. 2017; 53(9): 897-902. doi: 10.1111/jpc.13564

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Published

2022-07-08

How to Cite

Larry B. Mellick. (2022). Forty-Four Questions I Would Like to Ask Bronchiolitis Guideline Writers and Researchers. Emergency Medicine, 8(1), e1-e6. https://doi.org/10.17140/EMOJ-8-e007

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