Nebulized hypertonic saline for bronchiolitis in the emergency department: A randomized clinical trial

JAMA Pediatrics

Volumn 168, Issue 7, 2014, Pages 664-670

  Florin, Todd A ^a,b   Shaw, Kathy N ^c,d   Kittick, Marlena ^c   Yakscoe, Stephen ^c   Zorc, Joseph J ^c,d  

^a CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER   (United States)

^b UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE   (United States)

^c CHILDREN S HOSPITAL OF PHILADELPHIA   (United States)

^d UNIVERSITY OF PENNSYLVANIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

SALBUTAMOL; SODIUM CHLORIDE;

ARTICLE; BRONCHIOLITIS; CHILD; CONTROLLED STUDY; EMERGENCY WARD; FEMALE; FOLLOW UP; HEALTH CARE PERSONNEL; HEART RATE; HOSPITALIZATION; HUMAN; INFANT DISEASE; MAJOR CLINICAL STUDY; MALE; NAMED INVENTORIES, QUESTIONNAIRES AND RATING SCALES; NEBULIZATION; OUTCOME ASSESSMENT; OXYGEN SATURATION; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; RESPIRATORY DISTRESS; RESPIRATORY DISTRESS ASSESSMENT INSTRUMENT SCORE; SINGLE BLIND PROCEDURE; VITAL SIGN;

ACUTE DISEASE; ALBUTEROL; BRONCHIOLITIS; BRONCHODILATOR AGENTS; DOUBLE-BLIND METHOD; EMERGENCY MEDICAL SERVICES; FEMALE; HUMANS; INFANT; MALE; NEBULIZERS AND VAPORIZERS; SALINE SOLUTION, HYPERTONIC; SEVERITY OF ILLNESS INDEX; TREATMENT OUTCOME; URBAN HEALTH;

EID: 84904168097     PISSN: 21686203     EISSN: None     Source Type: Journal    
DOI: 10.1001/jamapediatrics.2013.5306     Document Type: Article

References (33)

1. Bordley WC, Viswanathan M, King VJ, et al. Diagnosis and testing in bronchiolitis: a systematic review. Arch Pediatr Adolesc Med. 2004;158(2):119-126.
2. King VJ, Viswanathan M, Bordley WC, et al. Pharmacologic treatment of bronchiolitis in infants and children: a systematic review. Arch Pediatr Adolesc Med. 2004;158(2):127-137. (Pubitemid 38173966)
3. Leader S, Kohlhase K. Recent trends in severe respiratory syncytial virus (RSV) among US infants, 1997 to 2000. J Pediatr. 2003;143(5)(suppl):S127-S132. (Pubitemid 37456910)
4. Shay DK, Holman RC, Newman RD, Liu LL, Stout JW, Anderson LJ. Bronchiolitis-associated hospitalizations among US children, 1980-1996. JAMA. 1999;282(15):1440-1446. (Pubitemid 29493797)
5. Pelletier AJ, Mansbach JM, Camargo CA Jr. Direct medical costs of bronchiolitis hospitalizations in the United States. Pediatrics. 2006;118(6):2418-2423. (Pubitemid 46397582)
6. Talbot AR, Herr TM, Parsons DS. Mucociliary clearance and buffered hypertonic saline solution. Laryngoscope. 1997;107(4):500-503. (Pubitemid 27176059)
7. Donaldson SH, Bennett WD, Zeman KL, Knowles MR, Tarran R, Boucher RC. Mucus clearance and lung function in cystic fibrosis with hypertonic saline. N Engl J Med. 2006;354(3):241-250. (Pubitemid 43113029)
8. Elkins MR, Robinson M, Rose BR, et al National Hypertonic Saline in Cystic Fibrosis (NHSCF) Study Group. A controlled trial of long-term inhaled hypertonic saline in patients with cystic fibrosis. N Engl J Med. 2006;354(3):229-240. (Pubitemid 43113028)
9. Eng PA, Morton J, Douglass JA, Riedler J, Wilson J, Robertson CF. Short-term efficacy of ultrasonically nebulized hypertonic saline in cystic fibrosis. Pediatr Pulmonol. 1996;21(2):77-83. (Pubitemid 26098513)
10. Pavia D, Thomson ML, Clarke SW. Enhanced clearance of secretions from the human lung after the administration of hypertonic saline aerosol. Am Rev Respir Dis. 1978;117(2):199-203. (Pubitemid 8319015)
11. Daviskas E, Anderson SD, Gonda I, et al. Inhalation of hypertonic saline aerosol enhances mucociliary clearance in asthmatic and healthy subjects. Eur Respir J. 1996;9(4):725-732. (Pubitemid 26167877)
12. Ziment I. Respiratory Pharmacology and Therapeutics. Philadelphia, PA:WB Saunders; 1978.
13. Assouline G, Leibson V, Danon A. Stimulation of prostaglandin output from rat stomach by hypertonic solutions. Eur J Pharmacol. 1977;44(3): 271-273. (Pubitemid 8148604)
14. Mandelberg A, Tal G, Witzling M, et al. Nebulized 3%hypertonic saline solution treatment in hospitalized infants with viral bronchiolitis. Chest. 2003;123(2):481-487. (Pubitemid 36269434)
15. Sarrell EM, Tal G, Witzling M, et al. Nebulized 3%hypertonic saline solution treatment in ambulatory children with viral bronchiolitis decreases symptoms. Chest. 2002;122(6):2015-2020. (Pubitemid 36051138)
16. Mandelberg A, Amirav I. Hypertonic saline or high volume normal saline for viral bronchiolitis: mechanisms and rationale. Pediatr Pulmonol. 2010; 45(1):36-40.
17. Kuzik BA, Al-Qadhi SA, Kent S, et al. Nebulized hypertonic saline in the treatment of viral bronchiolitis in infants. J Pediatr. 2007;151(3):266-270, e1. doi:10.1016/j.jpeds.2007.04.010.
18. Tal G, Cesar K, Oron A, Houri S, Ballin A, Mandelberg A. Hypertonic saline/epinephrine treatment in hospitalized infants with viral bronchiolitis reduces hospitalization stay: 2 years experience. Isr Med Assoc J. 2006;8(3):169-173.
19. Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP. Nebulised hypertonic saline solution for acute bronchiolitis in infants. Cochrane Database Syst Rev. 2013;7:CD006458. doi:10.1002/14651858.CD006458.pub3.
20. Grewal S, Ali S, McConnell DW, Vandermeer B, Klassen TP. A randomized trial of nebulized 3% hypertonic saline with epinephrine in the treatment of acute bronchiolitis in the emergency department. Arch Pediatr Adolesc Med. 2009;163 (11):1007-1012.
21. Kuzik BA, Flavin MP, Kent S, et al. Effect of inhaled hypertonic saline on hospital admission rate in children with viral bronchiolitis: a randomized trial. CJEM. 2010;12(6):477-484.
22. Lowell DI, Lister G, Von Koss H, McCarthy P. Wheezing in infants: the response to epinephrine. Pediatrics. 1987;79(6):939-945. (Pubitemid 17079009)
23. Klassen TP, Sutcliffe T, Watters LK, Wells GA, Allen UD, Li MM. Dexamethasone in salbutamol-treated inpatients with acute bronchiolitis: a randomized, controlled trial. J Pediatr. 1997;130(2):191-196. (Pubitemid 27495152)
24. Schuh S, Coates AL, Binnie R, et al. Efficacy of oral dexamethasone in outpatients with acute bronchiolitis. J Pediatr. 2002;140(1):27-32. (Pubitemid 34117463)
25. Klassen TP, Rowe PC, Sutcliffe T, Ropp LJ, McDowell IW, Li MM. Randomized trial of salbutamol in acute bronchiolitis. J Pediatr. 1991;118 (5):807-811.
26. Corneli HM, Zorc JJ, Mahajan P, et al Bronchiolitis Study Group of the Pediatric Emergency Care Applied Research Network (PECARN). A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis. N Engl J Med. 2007;357(4):331-339. (Pubitemid 47124133)
27. Schriger DL, Newman DH. Medical decision making: let's not forget the physician. Ann Emerg Med. 2012;59(3):219-220.
28. Ipek IOYE, Yalcin EU, Sezer RG, Bozaykut A. The efficacy of nebulized salbutamol, hypertonic saline and salbutamol/hypertonic saline combination in moderate bronchiolitis. Pulm Pharmacol Ther. 2011;24(6):633-637.
29. Prendiville A, Green S, Silverman M. Paradoxical response to nebulised salbutamol in wheezy infants, assessed by partial expiratory flow-volume curves. Thorax. 1987;42(2):86-91. (Pubitemid 17020307)
30. Prendiville A, Rose A, Maxwell DL, Silverman M. Hypoxaemia in wheezy infants after bronchodilator treatment. Arch Dis Child. 1987;62 (10):997-1000. (Pubitemid 17155043)
31. Ralston S, Hill V, Martinez M. Nebulized hypertonic saline without adjunctive bronchodilators for children with bronchiolitis. Pediatrics. 2010;126(3):e520-e525. doi:10.1542/peds .2009-3105.
32. Al-Ansari K, Sakran M, Davidson BL, El Sayyed R, Mahjoub H, Ibrahim K. Nebulized 5%or 3% hypertonic or 0.9%saline for treating acute bronchiolitis in infants. J Pediatr. 2010;157(4):630-634. doi:10.1016/j.jpeds.2010.04.074.
33. Robinson M, Hemming AL, Regnis JA, et al. Effect of increasing doses of hypertonic saline on mucociliary clearance in patients with cystic fibrosis. Thorax. 1997;52(10):900-903. (Pubitemid 27473934)