Multicenter Observational Study of the Use of Nebulized Hypertonic Saline to Treat Children Hospitalized for Bronchiolitis From 2008 to 2014

Abstract

Use of HTS in children hospitalized with bronchiolitis increased during the 2008 to 2012 winter seasons and then declined. These findings paralleled trends in the HTS literature, with positive articles encouraging HTS use in early years followed by a growing number of neutral and negative articles after 2012.

Hypertonic Saline in Bronchiolitis and Type I Error: A Trial Sequential Analysis

“…Hypertonic saline (HS) has been intensely scrutinized as a therapy for acute viral bronchiolitis, and its use varies widely between centers in the United States. 1 There is persistent debate around whether the therapy shortens hospital length of stay (LOS) or decreases risk of hospitalization, the most relevant studied outcomes. The existing evidence base includes conflicting results from individual trials, many of which are underpowered: a scenario in which meta-analysis is often considered the ideal method for achieving clarity.…”

Nebulised hypertonic saline in children with bronchiolitis admitted to the paediatric intensive care unit: A retrospective study

“…Our results showed that patients in the HS group required invasive ventilation for a significantly longer period. Nevertheless, no significant differences were found between the two groups in severity of disease, occurrence of complications or duration of treatment with antibiotics, minimising the risk of confounding by severity …”

“…desaturation, bradycardia, increased coughing and increased respiratory rate, were described . The equivocal results for the efficacy of HS, together with concerns about safety and tolerability, have led to a significant decrease in the use of HS, although controversies persist …”