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Efficacies of different treatment strategies for infants hospitalized with acute bronchiolitis
Hyeri Jeong1, Dawon Park1, Eun Kyo Ha2
1Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
Insights
Inhalation therapy with epinephrine and hypertonic saline effectively reduce hospital stays and symptom severity in infants with acute bronchiolitis. These findings offer valuable insights for managing this common childhood respiratory illness.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Evidence-Based Medicine
Background:
- Acute bronchiolitis is a frequent cause of infant hospitalization.
- It is associated with considerable morbidity and mortality rates.
Purpose of the Study:
- To compare the effectiveness of various bronchiolitis treatments in infants.
- Key outcomes include hospital stay duration and clinical severity scores.
Main Methods:
- Systematic review and meta-analysis of double-blind randomized controlled trials.
- Searched PubMed for studies on infants under 2 years, published up to July 2020.
- Analyzed 45 trials involving 5,061 participants and 13 interventions.
Main Results:
- Epinephrine and hypertonic saline inhalation therapies shortened hospital stays compared to normal saline.
- Hypertonic saline demonstrated the greatest improvement in clinical severity scores.
- Standardized mean differences (SMD) and confidence intervals (CI) were calculated for efficacy outcomes.
Conclusions:
- Epinephrine and hypertonic saline inhalation are effective treatments for acute bronchiolitis in infants.
- These therapies reduce both hospital stay duration and symptom severity.
- Supports evidence-based guidelines for infant bronchiolitis management.
Background:
Acute bronchiolitis is a common cause of hospitalization during infancy that carries significant morbidity and mortality rates.
Purpose:
This study compared the efficacy of different treatment modalities for infants with bronchiolitis in terms of hospital stay and clinical severity scores.
Methods:
The PubMed database was searched for relevant studies. Eligibility criteria included double-blind randomized controlled trial design, assessment of the effect of treatment on bronchiolitis in infants under 2 years of age, and publication in English from inception through July 31, 2020. The primary efficacy outcome was the length of hospital stay, while the secondary outcome was the clinical severity score. The standardized treatment effect and standard error of the effect size were calculated.
Results:
We identified 45 randomized controlled trials of 24 pairwise comparisons. These 45 trials included 5,061 participants and investigated 13 types of interventions (12 active, 1 placebo). Inhalation therapy with epinephrine (standard mean difference [SMD], -0.41; 95% confidence interval [CI], -0.8 to -0.03) and hypertonic saline (SMD, -0.29; 95% CI, -0.55 to -0.03) reduced the length of hospital stay compared with normal saline. Hypertonic saline was the most effective at improving the clinical severity score (SMD, -0.52; 95% CI, -0.95 to -0.10).
Conclusion:
Inhalation therapy with epinephrine and hypertonic saline reduced the length of hospital stay and the clinical severity of bronchiolitis among infants under 2 years of age.
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