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Agreements and controversies of national Guidelines for bronchiolitis: results from an Italian Survey among paediatricians.
  • +13
  • Sara Manti,
  • Amelia Licari,
  • Ilaria Brambilla,
  • Carlo Caffarelli,
  • Mauro Calvani,
  • Fabio Cardinale,
  • Giorgio Ciprandi,
  • Claudio Cravidi,
  • Marzia Duse,
  • Alberto Martelli,
  • Domenico Minasi,
  • Michele Miraglia del Giudice,
  • Giovan Battista Pajno,
  • Maria Angela Tosca,
  • Elena Chiappini,
  • Gian Luigi Marseglia
Sara Manti
University of Catania

Corresponding Author:saramanti@hotmail.it

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Amelia Licari
Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia
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Ilaria Brambilla
Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia
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Carlo Caffarelli
Università di Parma
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Mauro Calvani
Ospedale S. Camillo-Forlanini
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Fabio Cardinale
University of Bari
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Giorgio Ciprandi
Casa di Cura Villa Montallegro
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Claudio Cravidi
ATS Pavia
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Marzia Duse
Policlinico Umberto I, Università Sapienza di Roma
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Alberto Martelli
Azienda Ospedaliera G. Salvini, Ospedali di Garbagnate Milanese e Bollate
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Domenico Minasi
Grande Ospedale Metropolitano
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Michele Miraglia del Giudice
1Department of Woman, Child and of General and Specialized Surgery. University of Campania "Luigi Vanvitelli"
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Giovan Battista Pajno
Universita degli Studi di Messina
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Maria Angela Tosca
Istituto Giannina Gaslini
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Elena Chiappini
University of Florence
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Gian Luigi Marseglia
Department of Pediatrics, Foundation IRCCS Policlinico San Matteo, University of Pavia, Italy
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Abstract

Introduction. Significant variations in the management of bronchiolitis are often recorded, and, in parallel, to recommend a univocal clinical approach it is not easy and is still questioned. This study is aimed to evaluate the diagnostic and therapeutic management of bronchiolitis in children adopted by Italian paediatricians following the national guidelines. Material and methods. A survey study was designed and carried out by sending an email an open-ended questionnaire developed by an expert panel of the Scientific Board of the Italian Society of Pediatric Allergology and Immunology (SIAIP). Questions were designed according to the national inter-society consensus document on treatment and prevention of bronchiolitis in newborns and infants. Results. Overall, 234 paediatricians were taking part in the study. When diagnosing bronchiolitis, only 44.01% (103/234) of participants were correctly following the national guidelines. All participants (100%) would perform laboratory tests and/or radiological exams. 44.01% administered oxygen (O2) when O2 saturation was major than 92%. About the therapeutic regimen, marked discrepancies between national guidelines and recorded answers were reported. Indications for hospital admission and discharge criteria were in line with the national guidelines. Conclusions. There is a significant practise variation in the management of acute bronchiolitis among Italians physicians. Some wrong attitudes need to be further discouraged, such use of diagnostic procedures and therapeutic approaches. Further research is urgently required to define the best management of patients with bronchiolitis as well as implement strategies to standardize care and improve the quality of care.