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Nebulized Hypertonic Saline for Acute Bronchiolitis: A Systematic Review.

Linjie Zhang¹, Raúl A Mendoza-Sassi², Terry P Klassen³

¹Faculty of Medicine, Federal University of Rio Grande, Rio Grande, Brazil; lzhang@furg.br linjie.zhang@pq.cnpq.br.

|September 30, 2015

Summary

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Nebulized hypertonic saline (HS) offers a safe and effective treatment for infants with acute bronchiolitis, potentially reducing hospital stays and improving clinical scores. This approach provides a valuable alternative to standard supportive care for this common respiratory illness.

Area of Science:

Pediatric Respiratory Medicine
Critical Care Medicine
Evidence-Based Medicine

Background:

Acute bronchiolitis is a common viral respiratory infection in infants, primarily managed with supportive care.
Current treatment strategies for acute bronchiolitis lack specific targeted therapies, highlighting the need for effective interventions.

Purpose of the Study:

To evaluate the efficacy and safety of nebulized hypertonic saline (HS) as a treatment for acute bronchiolitis in infants.
To compare nebulized HS with standard care or 0.9% saline in terms of clinical outcomes and safety.

Main Methods:

A systematic review and meta-analysis of randomized and quasi-randomized controlled trials were conducted.
Databases searched included PubMed and the Virtual Health Library up to May 2015.

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Included studies compared nebulized HS with 0.9% saline or standard treatment in infants with acute bronchiolitis.

Main Results:

Nebulized HS significantly reduced length of hospital stay for inpatients (MD -0.45 days).
Inpatients receiving HS showed significantly lower posttreatment clinical scores in the first three days.
Outpatients treated with nebulized HS experienced a 20% reduced risk of hospitalization compared to 0.9% saline.
No significant adverse events were associated with nebulized HS inhalation.

Conclusions:

Nebulized hypertonic saline (HS) is a safe and potentially effective treatment for infants diagnosed with acute bronchiolitis.
The findings suggest HS can improve clinical outcomes and reduce healthcare utilization in this patient population.
Moderate quality of evidence indicates potential benefits, though further research may be warranted due to study limitations.