Risk of Respiratory Failure, Pneumonia, and Apnea in Children with Acute Bronchiolitis

Acute bronchiolitis is a common respiratory illness in young children, particularly those under two years of age. If not detected early and treated promptly, it can lead to a range of serious complications including pneumonia, lung collapse, middle ear infections, respiratory failure, and even death.

Understanding Acute Bronchiolitis

Acute bronchiolitis is an acute infection of the bronchioles that severely affects the respiratory system of young children, especially those under two. When viruses attack, the tiny airways become inflamed and obstructed, making it difficult for air to flow into the alveoli, which causes breathing difficulties.

According to experts, infants and children under two are more susceptible to respiratory infections due to their underdeveloped respiratory systems. Poor lung elasticity, thin pleural membranes, and short airways result in a higher need for gas exchange, increasing their risk of infection. Among these, bronchiolitis is one of the most common conditions.

Although any child can develop this illness, the following groups are at higher risk:

• Children under 2 years old, especially those aged 3–6 months

• Premature infants (born before 36 weeks) or low birth weight (under 2.5 kg)

• Children not exclusively breastfed

• Children with a history of viral infections such as rhinitis, tonsillitis, or adenoiditis

• Children with congenital heart or lung diseases

• Children with weakened immune systems

• Children living with family members who have acute bronchiolitis

• Children exposed to smoke, pollutants, or drastic changes in weather

Early recognition and preventive measures can reduce the risk of infection and potential complications.

Causes of Acute Bronchiolitis in Children

The primary cause of acute bronchiolitis in children is respiratory viruses, most commonly the Respiratory Syncytial Virus (RSV), as well as influenza, rhinovirus, adenovirus, parainfluenza, and other viruses. Bacterial infections are rare but possible.

Once inside the body, the virus rapidly replicates in the upper respiratory tract (nose, mouth, throat), then spreads to the trachea and lungs, causing inflammation and swelling in the airways. It may also damage or destroy respiratory cells, making breathing difficult. The disease spreads primarily through direct contact with respiratory secretions via sneezing, coughing, speaking, or touching contaminated surfaces and then touching the face.

RSV accounts for 30–50% of all cases and is highly contagious, often leading to outbreaks. While older children may experience mild symptoms, infants under two years are more prone to severe progression. Influenza viruses are responsible for about 25% of cases, and adenovirus for around 10%.

Signs and Symptoms of Acute Bronchiolitis in Children

Early-stage bronchiolitis may resemble a common cold, presenting with nasal congestion, runny nose, mild cough, and fever. These symptoms may persist for 1–2 days before worsening into:

• Persistent or severe coughing, sometimes causing vomiting

• Fever lasting more than three days

• Fatigue, irritability, lethargy

• Wheezing, labored breathing, chest retractions during inhalation

• Abnormally fast breathing

• Slight cyanosis (bluish lips or fingertips due to lack of oxygen)

• Diarrhea, dehydration, difficulty drinking or breastfeeding

Without early detection and intervention, bronchiolitis can cause serious complications such as pneumonia, lung collapse, middle ear infections, or respiratory failure, posing life-threatening risks.

Parents should closely monitor children, especially if the following severe symptoms appear:

• Rapid, shallow breathing (over 60 breaths/min)

• Noticeable chest retractions during inhalation

• Lethargy or difficulty waking the child

• Refusal to drink fluids or signs of dehydration

• Blue-tinted lips, nails, or skin

• Difficulty eating or abnormally fast breathing

Seek medical attention immediately if any of these signs are present to avoid dangerous complications.

How Dangerous Can Acute Bronchiolitis Be?

In children under two or those with weakened immune systems, acute bronchiolitis can cause severe complications. The most serious risk is acute respiratory failure, where airway inflammation and blockage restrict airflow, potentially leading to temporary apnea. Without timely treatment, respiratory failure may cause hypoxemia, brain damage, and affect other vital organs.

Other complications include pneumonia or lung collapse as the virus penetrates deeper into the respiratory tract, causing more severe infections. Repeated bronchiolitis episodes may also irritate the airways, increasing the risk of developing asthma later in life.

Early detection and treatment are key to preventing complications and aiding faster recovery.

Preventing Acute Bronchiolitis in Children

To reduce the risk of acute bronchiolitis, parents should maintain a clean, well-ventilated living environment for their children. If anyone smokes in the household, avoid exposing children to secondhand smoke, which irritates the airways. Limit contact with individuals showing symptoms of respiratory infections.

Regular handwashing before caring for children is a simple but effective way to prevent virus transmission. Ensure children receive a balanced diet to strengthen their immune system and maintain exclusive breastfeeding for the first six months. Parents should also ensure timely vaccination to protect against severe respiratory illnesses.

Why Choose H PLUS?

• Professional medical team: H PLUS brings together experienced Vietnamese and Korean healthcare professionals dedicated to your child’s well-being.

• Modern medical equipment: Advanced diagnostic and treatment technologies for accurate and efficient care.

• International-standard vaccination services: Guaranteed safety and effectiveness, protecting your child from serious respiratory diseases and other health risks.

For consultation and appointment booking, please contact our hotline at +84 24-7306-9889.

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