Viral bronchiolitis management in hospitals in the UK

Carande, EJ; Galiza, EP; Nickless, A; Pollard, AJ; Drysdale, SB

Journal article

Viral bronchiolitis management in hospitals in the UK

Abstract:: Background Viral bronchiolitis is the leading cause of hospitalisation in infants less than a year old. The United Kingdom (UK) National Institute for Health and Care Excellence (NICE) published a guideline for the management of viral bronchiolitis in June 2015. Objectives This study aimed to prospectively survey the management of viral bronchiolitis in hospital Trusts in the UK to provide a baseline of practice prior to the publication of the 2015 NICE bronchiolitis guideline against which future practice can be assessed. Study design An electronic, structured questionnaire was sent to hospital paediatricians in the UK prior to the publication of the NICE bronchiolitis guideline via the Royal College of Paediatrics and Child Health e-portfolio system to assess the quality of Trust’s viral bronchiolitis management guidelines. Results Paediatricians from 111 (65% of all) UK Trusts completed an electronic questionnaire. 91% of Trusts had a bronchiolitis guideline. Overall only 18% of Trusts would be fully compliant with the NICE guideline. Between 43–100% of Trusts would be compliant with different sections of the guideline. There was variation in hospital admission criteria with respect to the need for supplemental oxygen (oxygen saturations <88% to <95%). ‘Unnecessary’ medications (especially bronchodilators, nebulised hypertonic saline and antibiotics) and investigations (chest x-ray and blood gas) were regularly advised. 72% of Trusts advised respiratory virus testing in all hospitalised infants and 64% created bronchiolitis bays to cohort infants. Conclusions There was wide variation in the management of infants with bronchiolitis in Trusts. Most bronchiolitic infants are not managed optimally in hospitals. Future guidelines should include advice on virus testing and isolation/cohorting.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Carande, E. J., Galiza, E. P., Nickless, A., Pollard, A. J., & Drysdale, S. B. (2018). Viral bronchiolitis management in hospitals in the UK. Journal of Clinical Virology, 104, 29–33.

MLA Style

Carande, EJ, et al. “Viral Bronchiolitis Management in Hospitals in the UK.” Journal of Clinical Virology, vol. 104, 2018, pp. 29–33.

Chicago Style

Carande, EJ, EP Galiza, A Nickless, AJ Pollard, and SB Drysdale. 2018. “Viral Bronchiolitis Management in Hospitals in the UK.” Journal of Clinical Virology 104: 29–33.
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