Supportive: correct oxygenation, nasal suctioning and hydration
Treated as outpatients (only if severe, hospitalization).
Hospitalize if marked respiratory distress, O2 sat < 92%, toxic appearance,
dehydration, poor oral feeding, prematurity (<34 weeks), age <3 months,
cardiopulmonary disease, unreliable parents.
Inpatients treated with contact isolation, hydration, O2, trial of aerosolized
albuterol. If it works continue.
RSV prophylaxis is recommended for high risk patients: poly or monoclonal
antibodies (palivizumab (Synagis) or intravenous RSV immune globulin (RSV-IG
No prior hx of wheeze
Supplemental oxygen (if O2 sat <92% +- mechanical ventilation
Ribavirin in cystic fibrosis, immunosuppressed.
Prior hx of wheeze
The same above and...
Corticosteroids: prednisone 2mg/kg/day orally given in 2 doses (not
recommended in bronchiolitis; some clinicians use it because the infant is
most likely to have asthma).