In My Opinion
By this time in the year, everyone has likely seen quite a bit of bronchiolitis. We’ve have tried suctioning, nebulizers, maybe even steroids, and the baby is still grunting and working hard to breathe. What next besides routine humidified oxygen or intubation? Is there any bridge therapy to prevent the intubation? Non-invasive ventilatory strategies like continuous positive airway pressure (CPAP) have been employed in the treatment of bronchiolitis, and they have been shown to be useful at preventing intubations and improving ventilation. However, CPAP may be technically difficult to use and is sometimes poorly tolerated by small children and infants. What about high flow nasal cannulae oxygen therapy (HFNC)? There is little data with its use in bronchiolitis, but one recently published study addresses this very question.
Are you still routinely doing blood cultures to look for occult bacteremia in the healthy-looking infant with fever without a source? If you are, then read this study.