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Nebulised deoxyribonuclease for viral bronchiolitis in children younger than 24 months

Bronchiolitis is the most common respiratory illness leading to hospitalisations in infants. Viral infections, particularly respiratory syncytial virus, are the usual cause, which lead to blockage of the small airways of the lungs due to inflammation and increased mucus production. Afflicted children have fever, cough, wheezing and difficulty breathing. Treatment is usually supportive. In bronchiolitis, the mucus produced contains large amounts of DNA, which makes it thicker and stickier. Removal of this DNA facilitates clearance of the mucus. RhDNase is an enzyme that breaks down DNA and hence may improve symptoms. We performed this review to assess the effect of rhDNase delivered through a nebuliser in children under 24 months old hospitalised for bronchiolitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Epinephrine for acute viral bronchiolitis in children less than two years of age

Bronchiolitis is the most common acute infection of the airways and lungs during the first years of life. It is caused by viruses, the most common being respiratory syncytial virus. The illness starts similarly to a cold, with symptoms such as a runny nose, mild fever and cough. It later leads to fast, troubled and often noisy breathing (for example, wheezing). While the disease is often mild for most healthy babies and young children, it is a major cause of clinical illness and financial health burden worldwide. Hospitalizations have risen in high‐income countries, there is substantial healthcare use, and bronchiolitis may be linked with preschool wheezing disorders and the child later developing asthma.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Steam inhalation or humidified oxygen for acute bronchiolitis in children under three years of age

Bronchiolitis is the commonest respiratory infection in young children up to three years of age. It is commonly caused by respiratory syncytial virus. Children with bronchiolitis have a cough, fast and difficult breathing, nasal congestion, fever and wheeze. The disease is treated using drugs (bronchodilators and corticosteroids) and humidified air.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Antibiotics for persistent cough or wheeze following acute bronchiolitis in children

Bronchiolitis is a common lung infection, affecting children across the world. It is usually caused by a virus called RSV (respiratory syncytial virus) but other viruses can cause this too. Young children with bronchiolitis normally have a cough, fast and difficult breathing, and poor feeding. Antibiotics are not normally prescribed to children with bronchiolitis unless there is concern of a secondary bacterial infection. However, some children continue to have ongoing problems (i.e. wheeze, cough) after the acute viral infection (> 14 days); increasing the risk of burden of disease and cost to the health system. These children often re‐present for further medical care in the community (general practitioners and health providers) or in hospital (emergency departments). Antibiotics may help treat these ongoing symptoms and get rid of the bacteria in the lungs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Hypertonic saline solution administered via nebuliser for acute bronchiolitis in infants

Acute viral bronchiolitis is the most common lower respiratory tract infection in infants up to two years old. Currently there is no effective treatment so standard treatment remains supportive care. Airway oedema (abnormal accumulation of fluid) and mucus plugging can cause wheezing and difficulty breathing in these patients. Nebulised hypertonic saline may be a beneficial treatment to manage acute bronchiolitis because it can improve airway hygiene. This review was conducted to assess the effects of hypertonic (≥ 3%) saline solution administered via a nebuliser in infants with acute bronchiolitis, compared with nebulised normal (0.9%) saline. The establishment of a therapeutic role for hypertonic saline solution may provide a cheap and effective therapy for these patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Usefulness of surfactant for bronchiolitis in seriously ill infants and children

Bronchiolitis (infection of small airways in the lungs) is one of the most common causes of respiratory failure in infants. There are no established treatment options for bronchiolitis. Surfactant may be useful in bronchiolitis because of its favourable effect on lung mechanics. We wanted to evaluate the efficacy of exogenous surfactant in reducing mortality and the duration of ventilation in infants and children with bronchiolitis, requiring mechanical ventilation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Glucocorticoids for acute viral bronchiolitis in infants and young children under two years of age

Bronchiolitis is the most common acute infection of the airways and lungs during the first years of life. It is caused by viruses, the most common being respiratory syncytial virus. The illness starts similar to a cold, with symptoms such as a runny nose, mild fever and cough. It later leads to fast, troubled and often noisy breathing (for example, wheezing). While the disease is often mild for most healthy babies and young children, it is a major cause of clinical illness and financial health burden worldwide. Hospitalisations have risen in high‐income countries, there is substantial healthcare use and bronchiolitis may be linked with preschool wheezing disorders and the child later developing asthma.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Bronchodilators for bronchiolitis for infants with first‐time wheezing

Bronchiolitis is an acute, highly contagious, viral infection of the lungs that is common in infants 0 to 12 months of age. It occurs every year in the winter months. It causes the small airways in the lungs to become inflamed and fill with debris. The airways are narrowed and this leads to blocking of the free passage of air. The infant has a harsh cough, runny nose and usually a fever. S/he can become breathless, wheezy and short of oxygen.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Chest physiotherapy for acute bronchiolitis in children younger than two years of age

We reviewed the evidence about the effect of chest physiotherapy in infants younger than two years of age with acute bronchiolitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Antibiotics for bronchiolitis in children under two years of age

We reviewed the evidence on the effect of antibiotics on clinical outcomes in children with bronchiolitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Heliox inhalation therapy for bronchiolitis in infants

We reviewed the evidence about the effect of heliox inhalation therapy in infants with airway obstruction due to winter viral pulmonary infection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Usefulness of continuous positive airway pressure (CPAP) for acute bronchiolitis in children

We reviewed the usefulness of continuous positive airway pressure (CPAP) for acute bronchiolitis in children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

High‐flow nasal cannula (tube) therapy for infants with bronchiolitis

Bronchiolitis is a common illness affecting the lower (smaller) respiratory airways in infants (younger than 24 months of age). Usually caused by a viral infection, it results in breathing problems, including cough, fast breathing, wheezing and can cause poor feeding. It is a major cause of hospitalisation in infants. Current treatment involves supporting infants to breath until the infection clears. An emerging method to support breathing is using blended, heated, humidified air and oxygen, through nasal cannulae (tubes) at flow rates higher than two litres per minute, which is the maximum for conventional dry oxygen delivery. This is known as high‐flow nasal cannula therapy and it allows the comfortable delivery of high flow rates of an air/oxygen blend which may improve ventilation. This may lead to a reduced need for invasive respiratory support (e.g. intubation) and may have a clinical advantage over other treatments by preventing drying of the upper airway. This review assessed the effects of high‐flow nasal cannula therapy, compared with other respiratory support, in the treatment of infants with bronchiolitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Leukotriene inhibitors for bronchiolitis in infants and young children

We reviewed the evidence regarding the effect of leukotriene inhibitors on clinical outcomes in infants and young children with bronchiolitis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Macrolides for diffuse panbronchiolitis

To summarise the evidence about the effect and safety of macrolide antibiotics for diffuse panbronchiolitis (DPB).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Oxygen therapy as part of the treatment for respiratory infections in children

We reviewed the evidence about the beneficial effect of oxygen supplementation therapy as part of the treatment for children with acute lower respiratory tract infection (LRTI). As oxygen may be administered using different delivery methods, we reviewed the most commonly used methods to deliver oxygen in children. As a secondary question, we reviewed the evidence regarding which signs or symptoms could indicate the need for oxygen therapy in children presenting with acute LRTI.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Continuous negative extrathoracic pressure or continuous positive airway pressure for children with acute respiratory failure and shortage of oxygen

Children develop respiratory failure and shortage of oxygen when they have infectious or non‐infectious respiratory illnesses. Continuous negative extrathoracic pressure (CNEP) which keeps lungs open by creating negative pressure on the chest or continuous positive airway pressure (CPAP) which keeps lungs open by delivering positive pressure in the lungs during all phases of breathing are used to help increase blood oxygen levels in respiratory failure and thereby reduce organ damage and risk of death. However, the safety and efficacy of these methods of respiratory support are uncertain. The searches for this review were updated in July 2013.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Inhaled corticosteroids for subacute cough in children

Cough is the most common symptom presenting to doctors. Cough in children negatively impacts on both children and their families, therefore any improvement would be beneficial. Treatment with inhaled corticosteroids may reduce the severity of subacute cough (coughing for two to four weeks) in children by reducing airway inflammation. Data from two small studies were available for inclusion in this review; however, both studies were in infants following hospitalisation for an acute bronchiolitis illness (98 infants in total). There was no difference between groups in the proportion of children 'not cured' at follow‐up. There were no significant side effects in either of these studies. Without further available evidence, recommendations for the use of inhaled corticosteroids for the treatment of subacute cough in children cannot be made. Further well‐designed studies, including children over 12 months of age, are required to determine whether treatment with inhaled corticosteroids can safely and effectively reduce the severity of subacute cough in children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Which drug to prevent lung transplant rejection provides best results with fewest adverse effects?

Almost everyone who receives a lung transplant is treated with the drugs tacrolimus or cyclosporin to prevent transplanted organ rejection. Both drugs have serious and common adverse effects. We aimed to compare the use of tacrolimus with cyclosporin to prevent organ rejection after lung transplantation to assess which drug worked best and had fewest adverse effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

High‐flow nasal cannula therapy for support of breathing in children

We reviewed evidence on the effectiveness of high‐flow nasal cannula (HFNC) therapy in supporting children's breathing. We found 11 studies in children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

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