title: [Update on the management of acute viral bronchiolitis: proposed guidelines of Grand Ouest University Hospitals].
abstract: OBJECTIVE
  While our European and North American colleagues have recently updated their recommendations, the 2000 Consensus Conference remains the main guideline on management of acute viral bronchiolitis in France. We aimed to establish an updated inter-regional protocol on management of acute viral bronchiolitis in infants.
  
  
  METHODS
  Pediatricians, pediatric pulmonologists, and emergency physicians of the Grand Ouest University Hospitals (France) gathered to analyze the recent data from the literature.
  
  
  RESULTS
  Criteria to distinguish childhood asthma from acute viral bronchiolitis were established, then prescriptions of diagnostic tests, antibiotics, and chest physiotherapy were defined and reserved for very limited situations. Similarly, the modalities of oxygen therapy prescription and nutritional support were proposed. Finally, other therapeutics such as nebulized hypertonic saline seem promising, but their place in the treatment of acute bronchiolitis in infants remains unclear.
  
  
  CONCLUSIONS
  This work has provided new proposals for management of acute viral bronchiolitis and helped standardize practices within the Grand Ouest University Hospitals. This local organization could lay the keystone for working toward guidelines initiated by learned societies at the national level.
authors: Service de pédiatrie générale, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France. Electronic address: marie.verstraete@chu-nantes.fr.
authors: M
authors: M
authors: Verstraete
authors: Service de pédiatrie générale, hôpital Morvan, CHU de Brest, 5, avenue Foch, 29609 Brest, France.
authors: P
authors: P
authors: Cros
authors: Service de pédiatrie générale, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors: M
authors: M
authors: Gouin
authors: Service de pédiatrie générale, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors: H
authors: H
authors: Oillic
authors: Service de pédiatrie générale, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors: T
authors: T
authors: Bihouée
authors: Service de pédiatrie générale, hôpital Morvan, CHU de Brest, 5, avenue Foch, 29609 Brest, France.
authors: H
authors: H
authors: Denoual
authors: Service de pédiatrie générale, hôpital Morvan, CHU de Brest, 5, avenue Foch, 29609 Brest, France.
authors: A
authors: A
authors: Barzic
authors: Service de pédiatrie générale, hôpital Morvan, CHU de Brest, 5, avenue Foch, 29609 Brest, France.
authors: A-L
authors: AL
authors: Duigou
authors: Service des urgences pédiatriques, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors: B
authors: B
authors: Vrignaud
authors: Service des urgences pédiatriques, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors: K
authors: K
authors: Levieux
authors: Service de pédiatrie générale, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors: N
authors: N
authors: Vabres
authors: Établissement de santé pour enfants et adolescents de la région nantaise (ESEAN), 58, rue des Bourdonnières, 44200 Nantes, France.
authors: E
authors: E
authors: Fleurence
authors: Service des urgences pédiatriques, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 9, France.
authors: E
authors: E
authors: Darviot
authors: Service des urgences pédiatriques, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.
authors: J
authors: J
authors: Cardona
authors: Service des urgences pédiatriques, hôpital Clocheville, CHU de Tours, 49, boulevard Béranger, 37000 Tours, France.
authors: M-A
authors: MA
authors: Guitteny
authors: Service des urgences pédiatriques, hôpital Clocheville, CHU de Tours, 49, boulevard Béranger, 37000 Tours, France.
authors: Y
authors: Y
authors: Marot
authors: Service de pédiatrie générale, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors: G
authors: G
authors: Picherot
authors: Service de pédiatrie générale, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France; Service de pédiatrie générale, hôpital Morvan, CHU de Brest, 5, avenue Foch, 29609 Brest, France; Service des urgences pédiatriques, hôpital Femme Enfant Adolescent, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors: C
authors: C
authors: Gras-Le Guen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis; D001990:Bronchiolitis, Viral / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D005602:France; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D033183:Interdisciplinary Communication; D008297:Male; D010348:Patient Care Team; D012138:Respiratory Therapy; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents