Australasian bronchiolitis guideline

Sharon O'Brien; Meredith L Borland; Elizabeth Cotterell; David Armstrong; Franz Babl; Paul Bauert; Christine Brabyn; Lydia Garside; Libby Haskell; David Levitt; Nicola McKay; Jocelyn Neutze; Andreas Schibler; Kam Sinn; Janine Spencer; Helen Stevens; David Thomas; Michael Zhang; Ed Oakley; Stuart R Dalziel; Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network, Australasia

doi:10.1111/jpc.14104

Australasian bronchiolitis guideline

J Paediatr Child Health. 2019 Jan;55(1):42-53. doi: 10.1111/jpc.14104. Epub 2018 Jul 15.

Authors

Sharon O'Brien^{1

2}, Meredith L Borland^{1

3}, Elizabeth Cotterell⁴, David Armstrong^{5

6}, Franz Babl^{7

8

9}, Paul Bauert¹⁰, Christine Brabyn¹¹, Lydia Garside¹², Libby Haskell¹³, David Levitt¹⁴, Nicola McKay¹⁵, Jocelyn Neutze¹⁶, Andreas Schibler^{14

17

18}, Kam Sinn¹⁹, Janine Spencer²⁰, Helen Stevens²¹, David Thomas²², Michael Zhang²³, Ed Oakley^{8

9

24

25}, Stuart R Dalziel^{13

26

27}; Paediatric Research in Emergency Departments International Collaborative (PREDICT) Network, Australasia

Affiliations

¹ Princess Margaret Hospital for Children, Perth, Western Australia, Australia.
² School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
³ Divisions of Paediatric and Emergency Medicine, School of Medicine, University of Western Australia, Perth, Western Australia, Australia.
⁴ Department of Paediatrics, School of Rural Medicine, University of New England, Armidale, New South Wales, Australia.
⁵ Department of Respiratory Medicine, Monash Children's Hospital, Melbourne, Victoria, Australia.
⁶ Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
⁷ Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.
⁸ Emergency Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
⁹ Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
¹⁰ Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
¹¹ Emergency Department, Waikato District Health Board, Hamilton, New Zealand.
¹² General Paediatrics, Sydney Children's Hospital, Sydney, New South Wales, Australia.
¹³ Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand.
¹⁴ University of Queensland, Brisbane, Queensland, Australia.
¹⁵ Children's Healthcare Network Western Region, Sydney, New South Wales, Australia.
¹⁶ Kidzfirst, Middlemore Hospital, Auckland, New Zealand.
¹⁷ Paediatric Intensive Care Unit, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia.
¹⁸ Paediatric Critical Care Research Group (PCCRG), Lady Cilento Children's Hospital, Brisbane, Queensland, Australia.
¹⁹ Emergency Department, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
²⁰ Department of Paediatrics, Fiona Stanley Hospital, Perth, Western Australia, Australia.
²¹ Children's Healthcare Network, Sydney, New South Wales, Australia.
²² General Paediatrics, Women's and Children's Hospital, Adelaide, South Australia, Australia.
²³ Emergency Department, John Hunter Hospital, Newcastle, New South Wales, Australia.
²⁴ Emergency Department, Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.
²⁵ Paediatric Emergency Medicine Centre of Research Excellence, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
²⁶ Department of Surgery, University of Auckland, Auckland, New Zealand.
²⁷ Department of Paediatrics: Youth and Child Health, University of Auckland, Auckland, New Zealand.

PMID: 30009459
DOI: 10.1111/jpc.14104

Abstract

Aim: Bronchiolitis is the most common lower respiratory tract disorder in infants aged less than 12 months, and research has demonstrated that there is substantial variation in practice patterns despite treatment being well defined. In order to align and improve the consistency of the management of bronchiolitis, an evidence-based guideline was developed for the Australasian population.

Methods: The guideline development committee included representation from emergency and paediatric specialty medical and nursing personnel in addition to geographical representation across Australia and New Zealand - rural, remote and metropolitan. Formulation of the guideline included identification of population, intervention, comparator, outcomes and time questions and was associated with an extensive literature search from 2000 to 2015. Evidence was summarised and graded using the National Health and Medical Research Council and Grading of Recommendations Assessment, Development and Evaluation methodology, and consensus within the guideline group was sought using nominal group technique principles to formulate the clinical practice recommendations. The guideline was reviewed and endorsed by key paediatric health bodies.

Results: The guideline consists of a usable clinical interface for bedside functionality supported by evidence summary and tables. The Grading of Recommendations Assessment, Development and Evaluation and National Health and Medical Research Council processes provided a systematic and transparent process to review and assess the literature, resulting in a guideline that is relevant to the management of bronchiolitis in the Australasian setting.

Conclusion: This is the first robust Australasian acute paediatric guideline and provides clear guidance for the management of the vast majority of patients seen in Australasian emergency departments and general paediatric wards with bronchiolitis.

Keywords: bronchiolitis; guideline; management; paediatric; respiratory.

Publication types

Practice Guideline

MeSH terms

Australasia
Bronchiolitis / diagnosis
Bronchiolitis / drug therapy
Bronchiolitis / therapy*
Bronchiolitis / virology
Hospitalization
Humans
Infant
Oximetry
Oxygen Inhalation Therapy
Respiratory Syncytial Virus Infections / diagnosis

Grants and funding

GNT1058560/National Health and Medical Research Council Centre of Research Excellence grant