Viral bronchiolitis in the era of monoclonal antibodies and vaccines against respiratory syncytial virus

Abstract

Bronchiolitis is an acute viral disease that often represents the first obstructive episode in an infant and may be recurrent. Many respiratory viruses may be causative, but respiratory syncytial virus (RSV) is the most important.
For many years, pediatric intensive care units have experienced high occupancy rates during the winter months due to RSV bronchiolitis. The implementation of prevention strategies in recent years in some countries of the monoclonal antibody against RSV, nirsevimab, and the RSV vaccine in pregnant woman has transformed the epidemiology of the disease. The rate of hospitalizations and admissions to intensive care units has decreased significantly. This underscores the importance of prevention as the primary tool for its control. This situation presents new challenges in the clinical management of the disease.
The management consists of supportive therapy and treatment of respiratory failure. There is a lack of scientific evidence for other medical treatments other than oxygen.
This review evaluates the etiopathogenesis, clinical presentation, impact of RSV prevention strategies and the medical management of acute bronchiolitis.