ATS GUIDELINES Bundle

Infant Wheezing

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Issue link: http://eguideline.guidelinecentral.com/i/769848

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Key Points Î "Persistent infant wheezing" is herein defined as recurrent or persistent episodes of wheezing in infants <24 months old. Î Wheezing occurs commonly during infancy. In most cases, wheezing episodes are mild and easily treated. However, some infants will develop persistent or recurrent wheezing, which is often severe. Î Guidelines for diagnostic testing are lacking for wheezing infants. Î These guidelines address diagnostic tests that are frequently considered by pediatric pulmonologists and other clinicians when evaluating infantile wheezing, but are either controversial or a frequent source of uncertainty. Î For infants with persistent wheezing despite treatment with bronchodilators, inhaled corticosteroids, or systemic corticosteroids, the ATS suggests an airway survey via flexible fiberoptic bronchoscopy (conditional recommendation, very low quality of evidence). Î For infants with persistent wheezing despite treatment with bronchodilators, inhaled corticosteroids, or systemic corticosteroids, the ATS suggests bronchoalveolar lavage (BAL) (conditional recommendation, very low quality of evidence). Î The ATS recommends research studies in infants with persistent wheezing despite treatment with bronchodilators, inhaled corticosteroids, or systemic corticosteroids, which compare clinical outcomes among those who are managed according to results from infant pulmonary function testing using the raised- volume rapid thoracoabdominal compression (RVRTC) method versus those who are managed according to clinical assessment alone. Diagnosis

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