Agreements and controversies of national guidelines for bronchiolitis: Results from an Italian survey

Immunity, Inflammation and Disease

Maria A. Tosca¹  Giorgio Ciprandi²  Carlo Caffarelli³  Amelia Licari⁴  Ilaria Brambilla⁴  Gianluigi Marseglia⁴  Eugenio Baraldi⁵  Michele Miraglia Del Giudice⁶  Sara Manti⁷  Mauro Calvani⁸  Marzia Duse⁹  Giovan B. Pajno^1,10  Claudio Cravidi^1,11  Elena Chiappini^1,12  Alberto Martelli^1,13  Domenico Minasi^1,14  Fabio Cardinale^1,15 

[1] Allergologia Pediatrica, Istituto Giannina Gaslini Genova Italy;Casa di Cura Villa Montallegro Genoa Italy;Clinica Pediatrica, Dipartimento di Medicina e Chirurgia Università di Parma Parma Italy;Clinica Pediatrica, Fondazione IRCCS Policlinico “S. Matteo,” Università di Pavia Pavia Italy;Dipartimento della Donna e del Bambino Università di Padova Padova Italy;Dipartimento della Donna, del Bambino e di Chirurgia Generale e Specialistica, Università della Campania Luigi Vanvitelli Napoli Italy;Dipartimento di Medicina Clinica e Sperimentale Unità di Broncopneumologia Pediatrica, Università di Catania Catania Italy;Dipartimento di Pediatria Ospedale S. Camillo‐Forlanini Roma Italy;Dipartimento di Pediatria, Policlinico Umberto I, Università Sapienza di Roma Roma Italy;Dipartimento di Pediatria, Unità di Allergologia, Università di Messina Messina Italy;Family Paediatrics, ATS Pavia Pavia Italy;SODc Malattie Infettive AOU Meyer, Dipartimento di Scienze della Salute Università di Firenze Firenze Italy;UOC Pediatria, Azienda Ospedaliera G. Salvini, Ospedali di Garbagnate Milanese e Bollate Milano Italy;UOC Pediatria, Grande Ospedale Metropolitano Reggio Calabria Italy;UOC Pediatria, Servizio di Allergologia e Pneumologia Pediatrica, Azienda Ospedaliera‐Universitaria “Consorziale‐Policlinico,” Ospedale Pediatrico Giovanni XXIII Bari Italy;

关键词: bronchiolitis;    children;    guidelines;    survey;    treatment;   

DOI  :  10.1002/iid3.451

来源: DOAJ

【 摘 要 】

Abstract Introduction Significant variations in the management of bronchiolitis are often recorded, and, in parallel, to recommend a univocal clinical approach is challenging and still questioned. This study is aimed to evaluate the diagnostic and therapeutic management of bronchiolitis in children adopted by Italian pediatricians following the national guidelines. Material and Methods A survey study was designed and carried out by sending an email an open‐ended questionnaire developed by an expert panel of the Scientific Board of the Italian Society of Pediatric Allergology and Immunology (SIAIP). Questions were designed according to the national intersociety consensus document on treatment and prevention of bronchiolitis in newborns and infants. Results Overall, 234 pediatricians were taking part in the study. When diagnosing bronchiolitis, only 44.01% (103/234) of participants correctly followed the national guidelines. All participants (100%) would perform laboratory tests and/or radiological exams. 44.01% administered oxygen (O2) when O2 saturation was minor than 92%. About the therapeutic regimen, marked discrepancies between national guidelines and recorded answers were reported. Indications for hospital admission and discharge criteria were in line with the national guidelines. Conclusions There is a significant practice variation in the management of acute bronchiolitis among Italian physicians. Some wrong attitudes need to be further discouraged, such use of diagnostic procedures and therapeutic approaches. Further research is urgently required to define the best management of patients with bronchiolitis and implement strategies to standardize care and improve the quality of care.

【 授权许可】

Unknown