Acute Bronchiolitis

Acute Bronchiolitis

    * Introduction
    * Pathophysiology
    * Signs and symptoms
    * Diagnosis
    * Evolution and prognosis
    * Treatment
Tracheobronchitis with acute bronchiolitis, interstitial pneumonia and acute inflammatory Bronchopneumonia is a diffuse infection of lower respiratory tract. Respiratory infections are particularly important because of increased incidence, the high infectivity, and complications by superinfection etiological diversity.
Respiratory tract infections are classified as follows: upper respiratory tract infections, middle and bottom. In terms of etiologic tracheobronchitis and bronchiolitis are caused by influenza virus (most commonly in winter and spring), respiratory syncytial virus (RSV), measles virus, influenza B viruses are responsible for paragripale interstitial pneumonia and the etiologic agent may Bronchopneumonia one of: Mycoplasma, adenovirus, influenza virus, syncytial virus, Coxiella Burnett, Histoplasma, enteroviruses.
Bronchiolitis is an acute syndrome of acute obstructive bronsiolar. The disease is detected in the first 2 years of life, with a peak incidence at 6 months. Respiratory syncytial virus, responsible for 70% of cases of bronchiolitis is very aggressive because of cytotoxic effect, causing damage to the bronchial epithelium bronsiolar. Obstructive phenomena can be explained by the presence of infiltrated and thickened walls. In terms of the most important pathophysiological disorders are caused by obstruction bronsiolara, a consequence of the occurrence of edema and / or constriction. Resistance to air flow through bronsiole is relatively greater during expiration (dyspnea expiratory). Cause partial obstruction bronsiolara produce emphysema. In case of complete obstruction occurs atelectasis (absence of air in one area or throughout the lung area due to obstructions related bronsiei alveoli followed by collapse), the air is absorbed. Record gas exchange disorders causing hypoxia (low oxygen concentration in the blood) and hipercarbiei (high amount of carbon dioxide in the blood). The clinical picture is preceded by an infection of the upper airway. Abrupt onset, fever manifesting the syndrome and the occurrence of respiratory signs: cough, polipnee shortness of breath. Exhale is prolonged and noisy. The thorax is relaxed and hypersonic. Vesicular murmur is difficult to perceive. They listen and sibilant rales ronflante bilaterally. Worsen respiratory failure after a few hours of evolution and symptoms: tachypnea (respiratory rate increase), 60-80 breaths per minute, beating wings of the nose, irritating cough, cyanosis peribucala and the extremities. The patient may present and miscellaneous digestive disorders: nausea, vomiting, abdominal distension (bloating). Positive diagnosis is on the basis of clinical and paraclinical. It makes blood counts and chest radiograph, gas meter reveals hypoxia. Etiologic diagnosis is based on virus isolation and growth of specific antibodies. The differential diagnosis is with other causes of dyspnea. The evolution is favorable, the nature of the disease is benign, and healing occurs within 7-8 days. Bronchiolitis critical period is 2-3 days. If death occurs worsening respiratory failure. Disease are frequent complications of febrile seizures, otitis, pneumothorax, pneumomediastinum. Treatment is symptomatic and consists of oxygen, fluidifiante of bronchial secretions, shield to combat foot and proper hydration. Bronchiolitis caused by an administration responds well to antiviral agent ribavirin. In case of superinfection or complications (eg otitis) is given antibiotics. Most cases are treated at home. It is compulsory hospitalization of children younger than 6 months and those who have a high degree of respiratory failure manifested by an increase in respiratory rate at levels 50-60 breaths per minute while sleeping. There will also be hospitalized babies who have hypoxemia (oxygen pressure less than 60 mmHg), food intolerance and lack of proper care at home opportunities. Bronchiolitis is an acute diffuse inflammatory disease of the lower airways of small arms, their obstruction caused by the inflammatory process. Although the etiology is almost exclusively viral respiratory syncytial virus is responsible, occasionally can be confused with acute bronchiolitis Bacterial Bronchopneumonia.