Bronchiolitis Albuterol Use
Bronchiolitis Clinical Pathway Committee recommendation: The Bronchiolitis Clinical Pathway Committee recommends following the present standard of care (supportive care consisting of nasal or nasopharyngeal suctioning, supplemental oxygen, feeding and/or hydration, and/or antipyretics as needed) established based on the American Academy of Pediatrics (AAP) 2014 Clinical Practice Guideline for the management of bronchiolitis (Ralston et al., 2014). The AAP 2014 Clinical Practice Guideline provided a strong recommendation against the use of albuterol, or salbutamol, when treating infants or children with a diagnosis of bronchiolitis (Ralston et al., 2014).
Literature supporting this recommendation: Based on review of current literature, there is no evidence to support a change in practice. Studies comparing albuterol, or other bronchodilators, to no albuterol are lacking. When there is lack of scientific evidence standard work should be developed, implemented, and monitored.
Reference:
Ralston, S. L., Lieberthal, A. S., Meissner, H. C., Alverson, B. K., Baley, J. E., Gadomski, A. M., ... & Hernandez-Cancio, S. (2014). Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics, 134(5), e1474-e1502.
Critically Appraised Topic (CAT): Bronchiolitis and Albuterol Use
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.