Management and Prevention Strategies for Respiratory Syncytial Virus (RSV) Bronchiolitis in Infants and Young Children: A Review of Evidence-Based Practice Interventions

Allison C. Cooper; Nancy Cantey Banasiak; Patricia Jackson Allen

Disclosures

Pediatr Nurs. 2003;29(6) 

In This Article

Abstract and Introduction

Abstract

Respiratory syncytial virus (RSV) is the most common cause of bronchiolitis and pneumonia among infants and children. The purpose of this paper is to review the epidemiology, etiology, pathophysiology, clinical manifestations, risk factors, and assessment of RSV infection in infants and young children. There is a lack of consensus regarding the optimal treatment for children with RSV infection. Bronchodilators, racemic epinephrine, inhaled and systemic corticosteroids, RSV-immunoglobulin (RSV-IG), and ribavirin have all been used for treatment of children with RSV infection. A review of current research indicates supportive and symptomatic management should be the mainstay of treatment. Ultimately, prevention of infection through education and immunotherapy is the key to reducing the morbidity and mortality associated with RSV bronchiolitis.

Introduction

Respiratory syncytial virus (RSV), first isolated more than 40 years ago, is the most common pathogen of bronchiolitis and pneumonia among infants and children under 2 years of age (Hall, 2001; Panitch, 2001; Sorrentino, Powers, & The Palivizumab Outcomes Study Group, 2000). RSV infection commonly causes mild cold-like symptoms in older children and adults. However, in infants and toddlers RSV can cause more serious lower respiratory tract infection (LRTI), especially in premature infants with chronic lung or heart disease or those who are immunocompromised (Centers for Disease Control and Prevention [CDC], 2002). RSV infection has a substantial social impact, both in economic terms and human suffering (i.e. loss of work and wages, hospitalization, pulmonary sequela, or death of a child). Each year in the United States alone, it is estimated that 0.5% to 2% of infants and young children with RSV infection require hospitalization with an associated cost of $300 million (CDC, 2001). Unfortunately, there is a lack of consensus regarding the optimal treatment for children with RSV infection.

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