Hypertonic Saline Doesn't Improve Respiratory Distress
(HealthDay News) — For infants with bronchiolitis, the benefits of nebulized hypertonic saline (HS) vs. normal saline (NS) in the emergency department are limited, according to two studies published online May 26 in JAMA Pediatrics.
Todd A. Florin, MD, from the Cincinnati Children's Hospital Medical Center, and colleagues conducted a randomized clinical trial involving children aged 2 to <24 months with their first episode of bronchiolitis. Patients were randomized to nebulized 3% HS or NS (31 in each treatment arm) in the emergency department. The researchers found that the improvement in the median Respiratory Assessment Change Score was significantly less in the HS group versus the NS group (−1 vs. −5; P=0.01)
Susan Wu, MD, from the Children's Hospital Los Angeles, and colleagues compared the effect of nebulized 3% HS versus NS on admission rate and length of stay in children aged <24 months with bronchiolitis. One hundred ninety-seven patients were randomized to NS and 211 to HS in the emergency department. The researchers found that the admission rate was 28.9% in the HS group compared with 42.6% in the NS group (adjusted odds ratio, 0.49). The mean length of stay for hospitalized patients did not differ significantly between the groups (P=0.24).
"Rather than despair, we believe these two trials point us to the importance of using scientifically developed systematic reviews and meta-analyses to get the best sense of optimal treatment for children," write the authors of an accompanying editorial.