Acute Bronchiolitis - What Changed in 10 Years?

Background: Acute Bronchiolitis (AB) is a fairly common cause of hospitalization in children. In 2012, Portuguese national guidelines regarding the diagnosis and treatment of AB were issued, aiming to prevent doctors from requesting unnecessary diagnostic tests or using unhelpful drugs. The aim of this study is to determine if the guidelines were useful in changing the medical approach to children hospitalized with AB, in a second-level hospital.

Methods: Inclusion criteria: every child with a first episode of AB below the age of 23 months that was hospitalized in Centro Hospitalar do Médio Ave between October 2005 and March 2006 (Group A) and between October 2015 and March 2016 (Group B). Chi-square tests were performed, with a confidence interval of 95%.

Results: A total of 84 children were included, 45 in group A (51.1% male) and 39 in group B (56.4% male). Median age was 4 months and 2 months, respectively. 100% of the children in group A got a chest X-ray and 93.3% got their blood tested, whereas in group B the frequency of chest x-rays and blood tests was 74.4% in both categories. Comparing both groups, we have a significant reduction regarding the use of both tests (p

Conclusion: After the guidelines were published, there was a significant shift both in the use of diagnostic tests and therapeutic measures, however, there’s still room for improvement.