Maybe there is no such thing as bronchiolitis.

Viral bronchiolitis is the most common reason for infants to be admitted to hospital,1,2 yet we seem powerless to do much about it. Physicians who have been in practice for 30 years or more have ridden the rollercoaster of optimism following the publication of randomized controlled trials (RCTs) on bronchiolitis showing the efficacy of bronchodilators, steroids, hypertonic saline and so on, only to have that optimism crushed by subsequent trials with negative results. How is it possible that, as admission rates for bronchiolitis have tripled over the last three decades,3 research has produced only conflicting results leading to the conclusion that nothing works? It seems unlikely that we have simply failed (so far) to find the right treatment and just need to keep looking. Perhaps we are doing something fundamentally wrong.