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Acute bronchiolitis refers to airway inflammation and obstruction of the lower respiratory tract and is caused almost exclusively by viral infection in children younger than 2 years. Commonly, symptoms of bronchiolitis begin with rhinitis or congestion and cough and may develop into symptoms of increasing respiratory distress (tachypnea, wheezing, and accessory muscle use). (1) Severity of bronchiolitis can vary from mild symptoms that can be managed at home to acute respiratory failure requiring invasive ventilation. There is wide variation in care for infants admitted to the hospital with bronchiolitis, which persists despite the existence of guidelines. (2)(3)(4) In 2014, the American Academy of Pediatrics (AAP) published the “Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis” (1) (summarized in Table 1), an updated, revised version of a previous 2006...
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