Acute Bronchiolitis Evolution and prognosis

Acute Bronchiolitis
Evolution and prognosis
The disease often has a benign form and heal within 7-8 days. Severe forms of acute asphyxia may produce a syndrome manifested by intense cyanosis peribucal and the extremities, shortness of breath (artificial) - sometimes with pauses (apnea), sweating, impaired consciousness, translating hypercapnia hypertension with tachycardia. Most critical period of the disease is in the first 48-72 hours after the onset of cough and dyspnea, may appear very ill infant with respiratory failure and acidosis. After the critical period is a rapid improvement and healing occurs within a few days in most cases. In newborns, young infants and premature infants with severe respiratory acidosis uncompensated, severe dehydration secondary to water loss by tachypnea and inability fluid intake may need to install prolonged periods of apnea, tuburari acid-base balance, dehydration, acute bacterial complications; they will cause a 1% unfavorable evolution of the cases. Morbidity and mortality recorded a higher rate in infants with congenital heart disease, cystic fibrosis, immunodeficiency or chronic lung disease. Statistics show that the mortality rate caused by RSV bronchiolitis (respiratory syncytial virus) is continuously decreasing. It is the result of specific immunoprophylaxis to prevent disease by anti-respiratory syncytial virus (anti-RSV) or intravenously administered anti-RSV monoclonal antibody administered intramuscularly. Currently, these methods of prophylaxis in Romania are not available. Gradually, the temperature is normalized in the disease, gradually reduce dyspnea, but cough and bronchial rales persist longer. Pulmonary Supradistensia regress more slowly. Complications can occur such as febrile seizures, otitis, atelectaziile a lung segment or lobe, pneumothorax, pneumomediastinum, bacterial superinfection. Sometimes stands and the presence of sequelae: persistent atelectasis, pulmonary supradistensie localized exceptional chronic respiratory failure. Bacterial complications such as sepsis Bronchopneumonia or are unusual. In children with bronchiolitis evolution of preexisting heart disease will develop heart failure.