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Network Meta-Analysis Comparing the Efficacy of Therapeutic Treatments for Bronchiolitis in Children

Caili Guo1, Xiaomin Sun1, Xiaowen Wang1

  • 1Department of Respiratory, Children's Hospital of Zhengzhou City, Zhengzhou, Henan, China.

JPEN. Journal of Parenteral and Enteral Nutrition
|February 2, 2018
PubMed

Insights

Epinephrine with or without corticosteroids (EP ± CS) and epinephrine with or without hypertonic saline (EP ± HS) are recommended as the optimal bronchiolitis treatments for children, showing superior outcomes in clinical severity score and length of hospital stay.

Area of Science:

  • Pediatric Pulmonology
  • Critical Care Medicine
  • Evidence-Based Medicine

Background:

  • Bronchiolitis is a common pediatric respiratory infection.
  • Optimal treatment strategies for bronchiolitis remain under investigation.
  • Comparison of various therapeutic regimens is essential for evidence-based clinical practice.

Purpose of the Study:

  • To compare placebo with seven therapeutic regimens for bronchiolitis treatment.
  • To determine the optimal treatment for pediatric bronchiolitis.
  • To evaluate efficacy based on clinical severity score (CSS) and length of hospital stay (LHS).

Main Methods:

  • Network meta-analysis of 40 studies (1995-2016).
  • Utilized mean difference and standardized mean difference with 95% credible intervals.
  • Surface Under the Cumulative Ranking Curve (SUCRA) for therapy ranking.

Main Results:

  • No significant difference between 7 regimens and placebo for CSS.
  • Epinephrine with or without hypertonic saline (EP ± HS) and epinephrine with or without corticosteroids (EP ± CS) showed advantages for LHS over placebo and bronchodilator agents (BA).
  • SUCRA identified EP ± CS as most effective for CSS, and EP ± HS as most effective for LHS.

Conclusions:

  • EP ± CS and EP ± HS are recommended as first-line treatments for pediatric bronchiolitis.
  • These regimens demonstrate superior performance in reducing clinical severity and hospital stay.
  • Evidence supports the use of EP-based therapies for improved bronchiolitis management.
Abstract

Keywords:
bronchiolitischildrennetwork meta-analysistreatment efficacy

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