High flow therapy versus hypertonic saline in bronchiolitis: randomised controlled trial.

Area of Science:

• Pediatrics
• Respiratory Medicine
• Clinical Trials

Background:

• Bronchiolitis is a common viral respiratory infection in infants.
• Current treatments aim to alleviate respiratory distress and improve patient comfort.
• Heated humidified high-flow nasal cannula (HHHFNC) and inhaled hypertonic saline solution (HSS) are potential therapeutic options.

Purpose of the Study:

• To compare the efficacy of HHHFNC versus HSS in treating moderate acute bronchiolitis.
• To assess the impact of these treatments on respiratory distress, patient comfort, length of stay (LOS), and Paediatric Intensive Care Unit (PICU) admission rates.

Main Methods:

• A randomized clinical trial was conducted in two urban paediatric hospitalisation units.
• 75 infants up to 6 months old with moderate acute bronchiolitis (Respiratory Distress Assessment Instrument score ≥4) were enrolled.
• Patients were randomized to receive either HHHFNC or HSS, with all receiving epinephrine as a bronchodilator.

Main Results:

• No significant differences were observed in mean Respiratory Assessment Change Scores (RACS) or mean comfort scores between the HHHFNC and HSS groups.
• Length of hospital stay (LOS) and Paediatric Intensive Care Unit (PICU) admission rates were similar for both treatment groups.
• No adverse events were reported during the study period.

Conclusions:

• HHHFNC is not superior to HSS in managing moderate acute bronchiolitis.
• Both interventions demonstrated comparable effectiveness regarding clinical severity, comfort, LOS, and PICU admission rates.
• Further research may explore optimal treatment strategies for infant bronchiolitis.