Bronchiolitis and Respiratory Syncytial Virus (RSV)

Bronchiolitis is an infection of the bronchial passages of the lungs. In response to the infection these passages of the lung fill with mucus, blocking the passage of air and making it difficult to breathe.

In children the most common cause of this infection is Respiratory Syncytial Virus (RSV). RSV is highly contagious and very common from late fall through the spring. Most children are infected with RSV at some point in their childhood and in most cases it manifests as a common cold, and does not require medical intervention. However, some children exposed to RSV experience a much more severe reaction which leads to bronchiolitis and hospitalization.

Children hospitalized with RSV may require respiratory support while the infection resolves.

Vapotherm High Flow Therapy

Vapotherm HFT provides a high level of respiratory support through a nasal cannula. Breathing gas is delivered at high flow rates that flush expired air out of the nasopharyngeal cavity. This removes expired carbon dioxide and assures that each inspiration that reaches the lungs consists primarily of fresh, high oxygen breathing gas.

In order to deliver these high flow rates the gas is heated and humidified. High humidity means patients can comfortably receive high flows, and it also has the effect of loosening the mucous in the respiratory passageways. Because it is delivered by a simple open system nasal cannula it is easy for the patient to cough and clear their airway. This improves airway conductance which results in more inspired gas reaching the alveoli to improve ventilation and oxygenation.

Clinical Use & Setting Flow Rates

The flow rate level should be set to be sufficient to flush the respiratory dead space and reduce the work of breathing. In children the size of the respiratory dead space varies with the size and age of the child. The primary indication of an appropriate flow rate is clinical observation of a reduced work of breathing and respiration rate. Oxygenation is managed by adjusting the FiO2. As symptoms alleviate the patient can be weaned from the therapy by sequentially reducing the flow rates and FiO2.

For details on the mechanisms of action and clinical use of Vapotherm HFT click here.

To hear Dr. Alexandre Rotta’s webinar on the treatment of RSV click here.

For information on contraindications, please visit the Precision Flow product page.

RSV Symptoms

Because the virus is so common, and bronchiolitis such a severe reaction, RSV infection is one of the most common reasons for children to visit the Emergency Room or be admitted to the hospital. The symptoms of RSV include:
  • Coughing or wheezing
  • Difficulty or rapid breathing
  • Retractions/nasal flaring
  • Low-grade fever
  • Irritable and restless
  • Runny nose