2014 bronchiolitis guidelines focus on avoiding interventions

(HealthDay)—The 2014 new and updated guidelines for management of bronchiolitis largely focus on tests or treatments to avoid, according to a perspective piece published online April 6 in Pediatrics.

Ricardo A. Quinonez, M.D., from the Baylor College of Medicine in San Antonio, and Alan R. Schroeder, M.D., from the Santa Clara Valley Medical Center in San Jose, Calif., discuss the 2014 American Academy of Pediatrics' Clinical Practice Guideline on the Diagnosis, Management, and Prevention of Bronchiolitis.

The authors note that 10 of the 14 recommendations in the updated 2014 guidelines focus on tests or treatments to avoid. The emphasis seems to be on avoiding interventions that lack a favorable risk-benefit ratio, focusing on meaningful outcomes such as hospitalization, length of stay, and symptom duration. Recommendations from the new guidelines include omitting use of bronchodilators and allowing clinicians to omit use of pulse oximetry.

"It is courageous in its bold, yet strongly evidence-based pronouncements to avoid care where the benefits do not clearly outweigh the harms," the authors write. "We hope that clinicians embrace these new recommendations that put the focus back on the patient and encourage practitioners to safely do less."