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Background: Bronchiolitis is the most common reason for hospital admission in infants in Australia and Aotearoa New Zealand (AoNZ), with care historically affected by practice variation, including use of ineffective therapies. The Paediatric Research in Emergency Departments International Collaborative (PREDICT) developed the first Australasian (Australia, AoNZ) bronchiolitis guideline in 2016, providing evidence-based guidance on the management of infants (< 12 months of age), presenting or admitted to hospital with bronchiolitis. In 2022, PREDICT initiated a guideline update to include new evidence and expand the scope to include intensive care (up to intubation), management of SARS-CoV-2 co-infection, and respiratory syncytial virus prevention.
Aim: This article outlines the methodology used in the guideline update, following AGREE and CheckUp reporting standards.
Methods: A Guideline Advisory Group and Guideline Development Committee, consisting of 29 clinical and methodological experts from Australasia, developed the guideline with consumer input. Forty-one scoping questions on 25 topics were investigated. Systematic searches were performed by a subject librarian across five electronic databases (last search 24/01/24). Screening of 13,932 new articles occurred independently, in duplicate in two stages. The results of 431 articles were synthesized narratively and quantitatively where appropriate, per topic. Risk of bias was evaluated using appropriate tools. GRADE methodology was used to assess evidence quality and develop the recommendations, which were finalised through consensus voting across three guideline development meetings.
Results: The update produced 41 recommendations (33 evidence-based, 8 consensus-based; including 11 new and 7 with key revisions), covering bronchiolitis investigations, management and RSV prevention. Interest-holder groups consulted on the recommendations.
Conclusion: The Australasian Bronchiolitis Guideline was updated and expanded according to AGREE and CheckUp reporting standards.
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http://dx.doi.org/10.1111/jpc.70145 | DOI Listing |
Hosp Pediatr
September 2025
Division of Hospital Medicine, Children's National Hospital, Washington, District of Columbia.
Objective: To describe institutional variation in standardized order set (SOS) utilization and SOS infrastructure within a regional pediatric care network.
Patients And Methods: This preliminary cross-sectional study explores SOS utilization and infrastructure at 5 pediatric hospital medicine services across a regional network. SOS utilization was calculated as the proportion of patient encounters where a diagnosis-based SOS was used for patients admitted with a diagnosis of asthma, bronchiolitis, skin and soft tissue infection, gastroenteritis, or pneumonia between July 1, 2019, and June 30, 2023.
Cancer Radiother
September 2025
Department of Radiation Oncology, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
Purpose: Radiation-induced lung injury is relatively uncommon but disabling, and a dose-limiting factor in thoracic radiotherapy. This complication is mainly encountered following radiotherapy for lung cancers. We provide recommendations for good clinical practice, defining the prevention and management of radiation-induced lung injury.
View Article and Find Full Text PDFZ Rheumatol
July 2025
RZ Rheumazentrum Rheinland-Pfalz, Bad Kreuznach, Deutschland.
Pulmonary, renal and cardiovascular diseases as well as osteoporosis, must always be considered in the treatment of patients with inflammatory rheumatic diseases. Regardless of whether they are an organ manifestation of the underlying rheumatic disease, a medication side effect or a comorbidity, these diseases have a decisive influence on morbidity, mortality and the treatment decisions. This article is part 1 of a CME article containing information on current diagnostic and therapeutic recommendations for pulmonary and cardiovascular comorbidities.
View Article and Find Full Text PDFPediatr Pulmonol
July 2025
Division of Pediatric Pulmonary and Sleep Medicine, Children's National Hospital, Washington, DC, USA.
Background: Viral bronchiolitis is the most common cause of lower respiratory tract infection in infants and the leading cause of hospitalization in infants under 1 year of age. Most clinical practice guidelines (CPGs) recommend a minimalist management approach based on supportive therapy, focusing solely on maintaining oxygenation and hydration.
Objectives: To examine the reasons behind the poor adherence to evidence-based guidelines for bronchiolitis in real-world clinical practice and to explore potential strategies to improve future management.
J Paediatr Child Health
August 2025
Department of Respiratory Medicine, Sydney Children's Hospital, Randwick, New South Wales, Australia.