Bronchiolitis is defined by the textbook as, “a diffuse, inflammatory obstruction in the small airways or bronchioles occurring most commonly in children” (Heuther & McCance, 2012). It is an acute inflammatory disease of the lower respiratory tract that occurs most commonly in infants and is caused by infection with seasonal viruses such as respiratory synctial virus (RSV) (Zorc & Hall, 2010). Bronchiolitis often results from an obstruction of the small airways. It is the leading cause of infant hospitalization in the United States (Zorc & Hall 2010) and is arguably the most common significant medical illness of childhood, with at least “1 in 7 normal infants developing ...view middle of the document...
Bronchiolitis begins in the upper respiratory tract before then spreading to the lower respiratory tract within days. The viral infection causes inflammation of the bronchliar epithelium and penetration of the surrounded bronchi by white blood cells (Zorc & Hall, 2010). Necrosis of the cells in the small, lower airways occurs, and mucous secretions are increased (Conquest, Cremonesini, & Neill, 2013). Because of the ciliary damage in the infants’ lungs, it is almost impossible for the secretions to be cleared. Bronchiolar level obstruction is caused by these mucosusal secretions, as is desquamation of the dead skin cells and edema (Conquest, Cremonesini, & Neill, 2013). Plugs of soughed, necrotic epithelium and fibrin in the airways will cause partial or total obstruction to airflow, making it very difficult for he infant to exhale which will consequently result in air becoming trapped and will reduce gaseous exchange (Conquest, Cremonesini, & Neill, 2013).
Signs and Symptoms
Infants with acute bronchiolitis may present with a wide range of clinical symptoms and severity, from mild upper respiratory infections to impending respiratory failure. Typically, these symptoms include tachypnea, wheezing, cough, crackles, use of accessory muscles, and/or nasal flaring. An infant with bronchiolitis will often present as having a “seasonal viral illness characterized by fever, nasal discharge and a dry, wheezy cough” (Conquest, Cremonesini, & Neill, 2013). During the first seventy-two hours of illness, the infant typically becomes worse before the symptoms begin to improve. An infant with bronchiolitis will present with 2-3 days of symptoms similar to that of the common cold, which is then followed by worsening respiratory distress. Often times these infants are also febrile and have a decreased appetite (Conquest, Cremonesini, & Neill, 2013).
The diagnosis of bronchiolitis and its severity is dependant on the health care provider. Some practitioners with use diagnostic tests to determine if the cause of bronchiolitis is viral or bacterial, however new research has found that this testing may not be necessary (Alverson & Ralston, 2011). Viral detection and radiographs are two tests that are used by practitioners to diagnose bronchiolitis, however it is not necessary to identify the exact pathogen responsible for the individual case (Alverson & Ralston, 2011).
There is currently a...