Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: A randomized study

Garavello, Werner; Romagnoli, Marco; Sordo, Lorenza; Gaini, Renato Maria; Berardino, Cristina Di; Angrisano, A.

doi:10.1034/j.1399-3038.2003.00021.x

Cited by 113 publications

(122 citation statements)

References 8 publications

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“…Most of the studies of nasal irrigation have involved subjects with acute or chronic rhinosinusitis, but they have been criticized mainly because of their small patient populations and the fact that their enrolment methods are subject to bias and therefore influence the interpretation of the results (8)(9)(10). Nevertheless, some data suggest that nasal irrigation may be useful in controlling the symptoms of childhood AR and reducing the need for traditional oral antihistamine or intranasal steroid therapy (11)(12)(13), although it has not been clearly established whether normal or hypertonic saline should be preferred, or what procedure is best for ensuring good compliance in younger children. It is also unclear whether nasal irrigation can be effective in reducing the comorbidities associated with childhood AR.…”

mentioning

confidence: 99%

Hypertonic Saline is More Effective Than Normal Saline in Seasonal Allergic Rhinitis in Children

Marchisio

Varricchio

Baggi

et al. 2012

Int J Immunopathol Pharmacol

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Allergic rhinitis (AR) is a very common childhood disease that is associated with a significant reduction in the patients' quality of life. Its treatment combines educating the patients and their parents, immunotherapy and drug administration. However, even the best approach does not relieve the symptoms of a number of patients. Alternative therapies are particularly needed for children because the fear of adverse events frequently reduces parental compliance to the prescribed drugs, and immunotherapy is less easy to administer than in adults. In this prospective investigator-blinded study we evaluated whether children, with a documented history of seasonal grass pollen-related AR, benefit from nasal irrigation by assessing the effects on nasal signs and symptoms, on middle ear effusion and on adenoidal hypertrophy. We randomized children aged 5 to 9 years (median age 82 months) to normal saline or hypertonic saline (a 2.7% sodium chloride solution), administered twice-daily using a disposable 20 ml syringe, or no treatment. Nasal symptoms (rhinorrhea, itching, sneezing, nasal obstruction), swelling of turbinates, adenoid hypertrophy or middle ear effusion were assessed at baseline and after 4 weeks of treatment. Two hundred and twenty children (normal saline: 80; hypertonic saline: 80; no treatment: 60) completed the study. After four weeks, all the considered items were significantly reduced in the group receiving hypertonic saline (P <0.0001), whereas in the group receiving normal saline only rhinorrhea (P = 0.0002) and sneezing (P = 0.002) were significantly reduced. There was no significant change in any of the items in the control group. The duration of oral antihistamines was significantly lower in the children receiving hypertonic saline than in those treated with normal saline or in controls. No adverse events were reported and parental satisfaction and compliance with the procedure were globally very good, regardless of the solution used. Using our procedure, hypertonic saline is effective, inexpensive, safe, well tolerated and easily accepted by children with seasonal grass pollen-related AR and their parents. Our data suggest that nasal irrigation with hypertonic saline might be included in the wide spectrum of therapies recommended for grass-pollen AR.

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confidence: 99%

Hypertonic Saline is More Effective Than Normal Saline in Seasonal Allergic Rhinitis in Children

Marchisio

Varricchio

Baggi

et al. 2012

Int J Immunopathol Pharmacol

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“…These results create a need for further investigations in order to understand the clinical relevance of the phenomenon demonstrated. HS has some benefits in the treatment of allergic rhinitis and cystic fibrosis (30,31) and a salt chamber has been shown to be beneficial to asthmatic patients (32). Since bronchial challenge with exercise has some similarity to HS challenge, we may also speculate on the effect of exercise bronchoconstriction on nocturnal asthma.…”

Section: Discussionmentioning

confidence: 99%

Protective effect of bronchial challenge with hypertonic saline on nocturnal asthma

Borges

Ferraz

Terra-Filho

et al. 2008

Braz J Med Biol Res

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Inhalation of hypertonic saline (HS) causes bronchoconstriction in asthmatic subjects. Repeated inhalation of HS leads to substantially reduced bronchoconstriction, known as the refractory period. Refractoriness due to different stimuli has also been described (cross-refractoriness). Nocturnal asthma is defined as an increase in symptoms, need for medication, airway responsiveness, and/or worsening of lung function that usually occurs from 4 to 6 am. Our objective was to determine the effect of refractoriness on nocturnal asthma. The challenge test consisted of inhalations of 4.5% saline with increasing durations until a reduction of 20% in forced expiratory volume in 1 s (FEV 1 ) (PD 20 HS) or total time of 15.5 min. Twelve subjects with nocturnal asthma were challenged with HS at 16:00 and 18:00 h and FEV 1 was measured at 4:00 h. One to 2 weeks later, FEV 1 was determined at 16:00 and 4:00 h. LogPD 20 HS at 18:00 h was significantly greater than logPD 20 HS at 16:00 h, 0.51 ± 0.50 and 0.69 ± 0.60 mg, respectively (P = 0.0033). When subjects underwent two HS challenges in the afternoon, mean (± SD) FEV 1 reduction was 206 ± 414 mL or 9.81 ± 17.42%. On the control day (without challenge in the afternoon) FEV 1 reduction was 523 ± 308 mL or 22.75 ± 15.40% (P = 0.021). Baseline FEV 1 values did not differ significantly between the control and study days, 2.48 ± 0.62 and 2.36 ± 0.46 L, respectively. The refractory period following HS challenges reduces the nocturnal worsening of asthma. This new concept may provide beneficial applications to asthmatic patients.

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“…On the other hand, hypertonic solution may exert symptomatic activity in children with seasonal allergic rhinitis (18).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, preliminary evidence suggested that hypertonic saline nasal sprays alone are effective in treating nasal symptoms in children with seasonal allergic rhinitis (18). Therefore, the present study aimed at evaluating the effect ofintranasal hypertonic solution among children affected by AH.…”

mentioning

confidence: 99%

Hypertonic Saline Solution in Children with Adenoidal Hyperytrophy: Preliminary Evidence

Ciprandi

Varricchio

Capasso³

et al. 2007

Eur J Inflamm

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Adenoidal hypertrophy (AH) is a frequent problem in children. A preliminary study evidenced that intranasal hypertonic solutions may exert an anti-inflammatory activity. The aim of the study is to evaluate the effect of intranasal hypertonic or isotonic solutions in children affected with AH. For this purpose, 78 children with AH were evaluated in a randomised and controlled study. Inclusion criteria for the study required that each patient had to have a III or IV degree of AH on the initial endoscopic examination. Children were treated with intranasal hypertonic or isotonic saline solution for 8 weeks. After treatment, endoscopy was performed to evaluate AH degree. Hypertonic treatment was associated with significant (p

show abstract

Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: A randomized study

Cited by 113 publications

References 8 publications

Hypertonic Saline is More Effective Than Normal Saline in Seasonal Allergic Rhinitis in Children

Hypertonic Saline is More Effective Than Normal Saline in Seasonal Allergic Rhinitis in Children

Protective effect of bronchial challenge with hypertonic saline on nocturnal asthma

Hypertonic Saline Solution in Children with Adenoidal Hyperytrophy: Preliminary Evidence

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