Diretriz

WHO consolidated guidelines for the management of common childhood illness: management of asthma in children and adolescents and bronchiolitis in infants and young children

Ano de publicação

2026

Instituição emissora

World Health Organization

Links

Recomendações

10 recomendações incluídas

Nebulized ipratropium bromide should be added to standard first-line therapy with inhaled short-acting beta2 agonist (SABA) and systemic corticosteroids for severe paediatric asthma exacerbations in health facilities.

Status

Nova

Recomendado a favor

Forte

Certeza da evidência

Baixa

Nebulized ipratropium bromide should be added for moderate paediatric asthma exacerbations not responsive to initial standard first-line therapy with inhaled short-acting beta2 agonist (SABA) and systemic corticosteroids in health facilities.

Status

Atualizada

Recomendado a favor

Forte

Certeza da evidência

Baixa

Intravenous (IV) magnesium sulfate (as a single short infusion) should be used as second-line therapy for severe paediatric asthma exacerbations, and for moderate exacerbations not responsive to standard first-line therapy with inhaled/nebulized medicines (short-acting beta2 agonist (SABA) and ipratropium) and systemic corticosteroids in health care facilities.

Status

Atualizada

Recomendado a favor

Forte

Certeza da evidência

Baixa

Intravenous (IV) aminophylline should not be used as second-line therapy for severe paediatric asthma exacerbations in health care facilities if alternative second-line options are available.

Status

Atualizada

Recomendado contra

Condicional

Certeza da evidência

Baixa

Intravenous (IV) short-acting beta2 agonist (SABA) should be used as a potential second-line therapy for severe paediatric asthma exacerbations in addition to standard first-line therapy with inhaled/nebulized medicines (SABA and ipratropium) and systemic corticosteroids in health care facilities.

Status

Atualizada

Recomendado a favor

Forte

Certeza da evidência

Alta

Intravenous (IV) magnesium sulfate should be the preferred option for second-line therapy and IV short-acting beta2 agonist (SABA) the preferred option for third-line therapy in severe paediatric asthma exacerbations not responding to standard first-line therapy.

Status

Atualizada

Recomendado a favor

Condicional

Certeza da evidência

Muito baixa

Combination inhaler (steroid plus fast-onset long-acting beta2 agonist) maintenance and reliever therapy (MART) should be considered for children with persistent asthma symptoms requiring regular inhaled corticosteroids (ICS) treatment.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Moderada

In infants and children aged less than 2 years presenting or hospitalized with suspected bronchiolitis, routine use of chest X-ray is not suggested for the initial diagnosis and management of bronchiolitis.

Status

Nova

Recomendado contra

Condicional

Certeza da evidência

Muito baixa

In infants and children aged less than 2 years, hospitalized with acute bronchiolitis with hypoxaemia, humidified high-flow nasal cannula (HHFNC) oxygen is suggested rather than standard flow oxygen (SFO).

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Baixa

In infants and children aged less than 2 years presenting or hospitalized with bronchiolitis, a trial of nebulized hypertonic saline (3%) is suggested rather than no nebulization.

Status

Nova

Recomendado a favor

Condicional

Certeza da evidência

Baixa