I'm not sure it would be correct to view a 5 month old with typical RSV bronchiolitis as having temporary asthma induced by the virus. The current understanding of the physiology for that patient would be that the airways are filled with mucus, debris and inflammatory cells, with bronchial muscle playing a minimal, if any role at that age. For a 13 month old with wheezing triggered by rhinovirus the picture could be very different and more similar to an older patient with asthma. That is part of the rationale for the recommendations.
Joseph Zorc MD, MSCE
Direct Reply: https://www.docmatter.com/josephzorc
Director, Emergency Information Systems; Emergency Medicine Attending Physician; Professor of Pediatrics
Children's Hospital of Philadelphia
This is a reply to the discussion started by Todd Zimmerman DO:
Few years old but nice letter.
The recommendation to not use bronchodilators is not supported by the...
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