Bronchiolitis is a common acute viral infection of the lower respiratory tract, occurring during the first years of life. One in three infants will develop bronchiolitis and, of these, up to 3 per cent require hospital care, making this the most common cause of hospitalisation in infants. Incidence is higher in Maori, Pacifica and Indigenous populations and for children from lower socioeconomic environments. The definition of bronchiolitis varies and is sometimes used to describe any lower respiratory tract viral infection in infants including bronchitis (infection of the larger conducting airways), bronchiolitis (small airways) and pneumonia (involving the alveoli). 

While usually mild and self-limiting, bronchiolitis is associated with increased mortality and morbidity in infants and substantial socioeconomic costs, including loss of caregiver earnings. It has also been linked to an increased risk of chronic respiratory conditions such as asthma in later life.

Management of bronchiolitis is largely supportive but there is considerable debate about many commonly used interventions. Nurses are key providers of support and advice to parents and caregivers of children with bronchiolitis about care at home and when to seek help. In the primary and acute care settings, monitoring of an infant’s respiratory status and response to treatment depends on a detailed understanding of physiological and pathophysiological events underlying infant respiratory function in health and in response to infection.

After reading this article and completing the accompanying online learning activities you should be able to:

• Outline features of infant anatomy and physiology that increase vulnerability in the presence of viral respiratory tract infections.
• Discuss common causative organisms of bronchiolitis and their pathophysiological impact.
• Assess evidence for the effectiveness of commonly used therapies in the management of bronchiolitis.
• Describe measures used for prevention of bronchiolitis and the current status of vaccine development.

The PDF article accompanying this activity first appeared in the August 2015 issue of Kai Tiaki Nursing New Zealand. References for the printed version can be found under the "news" tab on the CPD4nurses.com home page.