Fast Five Quiz: Respiratory Syncytial Virus

Supatida Tengsupakul, MD


September 24, 2019

The mainstay treatment of patients with RSV infection is supportive care, including supplemental oxygen (in children with oxygen saturation < 90%), hydration and nutrition maintenance, and management of respiratory secretions using saline drops and a suction bulb.

Bronchodilators, epinephrine, and corticosteroids are not recommended for the treatment of typical RSV bronchiolitis because they have not been clinically proven to be effective. A brief trial of bronchodilator can be used, but this therapy should be discontinued if the patient does not show any clinical response. However, the 2014 American Academy of Pediatrics (AAP) clinical practice guideline for bronchiolitis does not recommend a trial of bronchodilator, owing to lack of an objective method to determine clinical response.

Nebulized hypertonic saline improves mucociliary clearance, but its use remains controversial. Current recommendations advise against routine use of hypertonic saline in the emergency department setting because it does not decrease hospitalization rates. However, hypertonic saline can be considered in hospitalized patients.

Chest physiotherapy is often used to mobilize secretion and reexpand a collapsed lung, but a recent meta-analysis did not find evidence to support routine use. Corticosteroids do not show consistent benefit in treatment of acute RSV bronchiolitis.

Learn more on managing RSV infection.


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