A 2-month-old infant presents with first episode of viral bronchiolitis (RSV-positive). SpO2 is 91% on air, moderate subcostal recessions, poor feeding (only 30% of usual intake). The most evidence-based intervention is:
- A Supplemental oxygen to maintain SpO2 ≥92% and nasogastric feeds ✓
- B Nebulised salbutamol 2.5 mg every 4 hours
- C Nebulised 3% hypertonic saline with supportive care
- D Oral prednisolone 1 mg/kg/day for 3 days
Correct answer: A. Supplemental oxygen to maintain SpO2 ≥92% and nasogastric feeds
Explanation
Bronchiolitis management is supportive; the most evidence-based interventions are supplemental oxygen to maintain SpO2 ≥92% and ensuring adequate hydration/nutrition via nasogastric tube when oral intake is insufficient. Cochrane reviews and NICE 2021 guidelines show no benefit from bronchodilators (salbutamol, adrenaline), hypertonic saline in the ED, or corticosteroids for acute bronchiolitis. Nasogastric feeds are preferred over intravenous fluids in infants with adequate gut function.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.