BMJ  2007;335:1037-1041 (17 November), doi:10.1136/bmj.39374.600081.AD

Clinical Review

Clinical Review

Acute bronchiolitis

Andrew Bush, professor of paediatric respirology1, Anne H Thomson, consultant in paediatric respiratory medicine2

1 Imperial School of Medicine at National Heart and Lung Institute, London SW3 6NP , 2 Oxford Children's Hospital, Oxford OX3 9DU

Correspondence to: A Bush, Department of Paediatric Respiratory Medicine, Royal Brompton Hospital, London SW3 6NP a.bush@rbh.nthames.nhs.uk

The first 150 words of the full text of this article appear below.


• Bronchiolitis caused by respiratory syncytial virus is an important and seasonal cause of respiratory morbidity in the first year of life
• No effective preventive or therapeutic strategies exist, and supportive management is offered
• Unnecessary investigations and ineffective treatment must be avoided
• Many infants have medium to long term post-bronchiolitic symptoms, which should not be confused with true asthma and which do not respond to any current treatments


Acute bronchiolitis is a clinical diagnosis. A UK Delphic process reached a 90% consensus that bronchiolitis "is a seasonal viral illness, characterised by fever, nasal discharge and dry, wheezy cough. On examination, there are fine inspiratory crackles and/or high-pitched expiratory wheeze."1 Internationally, the definition is sometimes broadened to include a first episode of acute viral wheeze. It is an annual and major cause of morbidity in infancy. Acute bronchiolitis is a very common serious respiratory illness in children. Inappropriate . . . [Full text of this article]

Box 4 Action to be taken at first review in hospital, according to oxygen saturation at initial pulse oximetry reading

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