Comparing the effect of zinc gluconate and placebo in the treatment                of tachypnea, dyspnea and fever in children aged 2 to 23 months with acute bronchiolitis

Ahadi, Adel; Mirzarahimi, Mehrdad; Barak, Manouchehr; Ahari, Saeid Sadeghieh; Reyhanian, Maryam

doi:10.18203/2349-3259.ijct20201711

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Two RCTs evaluated the effect of zinc on bronchiolitis in children under two years 34,35 . Ahadi et al found that children in the treatment group had shorter hospital LOS (4.14 ± 1.21 versus 4.64 ± 1.2 days; p=0.016) and less wheezing and rhinorrhea at 72 hours (16% vs 36%, p=0.023, 0 vs 12%, p=0.027, respectively).…”

Section: Resultsmentioning

confidence: 99%

Emergency care interventions for pediatric severe acute respiratory infections in low- and middle-income countries: a systematic review and narrative synthesis

Relan

Garbern

O’Reilly

et al. 2023

Preprint

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Background: Severe acute respiratory infections (SARIs) are the leading cause of pediatric death globally, particularly in low- and middle-income countries (LMICs). Given the potential rapid clinical decompensation and high mortality rate from SARIs, interventions that facilitate the early care of patients are critical to improving patient outcomes. The aim of this systematic review was to evaluate the impact of emergency care interventions on improving clinical outcomes of pediatric patients with SARIs in LMICs. Methods: PubMed, Global Health, and Global Index Medicus electronic databases were searched to identify peer-reviewed clinical trials or studies with comparator groups published before November 2020. All studies which evaluated acute and emergency care interventions on clinical outcomes for children (29 days to 19 years) with SARIs conducted in LMICs were included. Given the heterogeneity of interventions and outcomes, a narrative synthesis was performed. Bias was assessed using the Risk of Bias 2 and Risk of Bias in Non-Randomized Studies of Interventions. Results: 20,583 studies were screened, with 99 meeting criteria for final inclusion. The most common conditions studied were pneumonia or acute lower respiratory infection (61.6%) and bronchiolitis (29.3%). The majority of studies evaluated medications (80.8%), followed by respiratory support (14.1%) and supportive care (5%). The strongest evidence of benefit was found for respiratory support interventions such as improved medical oxygen systems to decrease risk of death. Results were notably inconclusive on the utility of continuous positive airway pressure (CPAP). Mixed results were found for interventions for bronchiolitis, although possible benefit was found for hypertonic nebulized saline to decrease hospital length of stay. Early use of adjuvant treatments such as Vitamin A, D, and zinc for pneumonia and bronchiolitis did not appear to have convincing evidence of benefit on clinical outcomes. Conclusions: While the burden of SARI in pediatric populations is high, few emergency care (EC) interventions have high quality evidence for benefit on clinical outcomes in LMICs. Respiratory support interventions have the strongest evidence for decreasing hospital length of stay and mortality and improvement of clinical status. Further research on the use of CPAP in diverse settings and populations is needed. A stronger evidence base for EC interventions for children with SARI, including metrics on the timing of interventions, is greatly needed.

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Section: Resultsmentioning

confidence: 99%

Emergency care interventions for pediatric severe acute respiratory infections in low- and middle-income countries: a systematic review and narrative synthesis

Relan

Garbern

O’Reilly

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Two RCTs evaluated the effect of zinc on bronchiolitis in children under two years [ 73 , 74 ]. Ahadi et al [ 73 ] found that children in the treatment group had shorter mean hospital LOS (4.14 (standard deviation (SD) = 1.21) vs 4.64 (SD = 1.2) days; P = 0.016) and less wheezing and rhinorrhoea at 72 hours (16% vs 36%, P = 0.023, 0 vs 12%, P = 0.027, respectively). Both found no difference in tachypnoea, retractions, or cyanosis at 24 hours in the treatment vs control group; both studies were deemed to have high risk of bias.…”

Section: Resultsmentioning

confidence: 99%

Emergency care interventions for paediatric severe acute respiratory infections in low- and middle-income countries: A systematic review and narrative synthesis

et al. 2023

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Background Severe acute respiratory infections (SARIs) are the leading cause of paediatric death globally, particularly in low- and middle-income countries (LMICs). Given the potential rapid clinical decompensation and high mortality rate from SARIs, interventions that facilitate the early care are critical to improving patient outcomes. Through this systematic review, we aimed to evaluate the impact of emergency care interventions on improving clinical outcomes of paediatric patients with SARIs in LMICs. Methods We searched PubMed, Global Health, and Global Index Medicus for peer-reviewed clinical trials or studies with comparator groups published before November 2020. We included all studies which evaluated acute and emergency care interventions on clinical outcomes for children (29 days to 19 years) with SARIs conducted in LMICs. Due to observed heterogeneity of interventions and outcomes, we performed narrative synthesis. We assessed bias using the Risk of Bias 2 and Risk of Bias in Non-Randomized Studies of Interventions tools. Results We screened 20 583, 99 of which met the inclusion criteria. Conditions studied included pneumonia or acute lower respiratory infection (61.6%) and bronchiolitis (29.3%). Studies evaluated medications (80.8%), respiratory support (14.1%), and supportive care (5%). We found the strongest evidence of benefit for decreasing risk of death for respiratory support interventions. Results were inconclusive on the utility of continuous positive airway pressure (CPAP). We found mixed results for interventions for bronchiolitis, but a possible benefit for hypertonic nebulised saline to decrease hospital length of stay. Early use of adjuvant treatments such as Vitamin A, D, and zinc for pneumonia and bronchiolitis did not appear to have convincing evidence of benefit on clinical outcomes. Conclusions Despite the high global burden of SARI in paediatric populations, few emergency care (EC) interventions have high quality evidence for benefit on clinical outcomes in LMICs. Respiratory support interventions have the strongest evidence for benefit. Further research on the use of CPAP in diverse settings is needed, as is a stronger evidence base for EC interventions for children with SARI, including metrics on the timing of interventions. Registration PROSPERO (CRD42020216117)

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“…11 Another study by Ahadi ,Mirzarahimiand Barakshowed that the use of zinc gluconate as a zinc supplement in infants with acute bronchiolitis could improve tachypnoea, dyspnoea and fever in children aged 2 to 23 months with acute bronchiolitis and decrease the duration of hospitalization. 12 The findings of some of the above studies are somewhat contradictory. If zinc can be successfully used in the treatment of acute bronchiolitis, then it may not only help to reduce morbidity but also reduce future episodes of wheezing in children.…”

Section: Discussionmentioning

confidence: 98%

The Role of Zinc in Acute Bronchiolitis in children less than 2 years old

Hyder,

Ahmed,

Yasmeen

2023

Northern Int. Med. Coll. J.

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Background: Bronchiolitis is an acute respiratory illness which is the leading cause of respiratory distress in infancy and early childhood with its greatest morbidity in infants. Although zinc supplementation is effective in both preventing and treating pneumonia but its role in acute bronchiolitis has rarely been examined. Objective: To assess the effect of zinc sulfate to improve the clinical manifestations of acute bronchiolitis (Severe cases) in children less than 2 years of age. Materials and Methods: This was a double blind randomized clinical trial on 70 patients aged 2 to 23 months admitted in the Pediatric ward of Khwaja Yunus Ali Medical College and Hospital from September 2019 to September 2020 with the diagnosis of acute bronchiolitis. Patients were randomly divided equally into 2 groups: a case group was assigned oral zinc sulfate and the control group received placebo. Results: Mean age of case group was 174.63±98.7 days and control group 176.86±97.43 days ( p=0.924) with male predominance in both groups. Symptoms and signs of acute bronchiolitis (Severe cases) were compared between the 2 groups during admission and then at 24, 48 and 72 hours after initiation of treatment. No statistically significant differences were observed between the 2 groups in improvement of symptoms and signs including fever, fast breathing, chest indrawing and wheezing on 48 and 72 hours after treatment with zinc sulfate ( p>0.05). The duration of hospitalization was 4.2±2.6 days in the case group and 4.4±2.2 days in the control group and this difference was not significant. Conclusion: The present study showed that zinc sulfate has no benefit in improving the clinical manifestations of acute bronchiolitis. Northern International Medical College Journal Vol. 12 No.2 Jan 2021, Page 535-538

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Comparing the effect of zinc gluconate and placebo in the treatment of tachypnea, dyspnea and fever in children aged 2 to 23 months with acute bronchiolitis

Cited by 4 publications

References 17 publications

Emergency care interventions for pediatric severe acute respiratory infections in low- and middle-income countries: a systematic review and narrative synthesis

Emergency care interventions for pediatric severe acute respiratory infections in low- and middle-income countries: a systematic review and narrative synthesis

Emergency care interventions for paediatric severe acute respiratory infections in low- and middle-income countries: A systematic review and narrative synthesis

The Role of Zinc in Acute Bronchiolitis in children less than 2 years old

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