Hypertonic saline and adrenaline nebulization in the treatment of bronchiolitis: a retrospective study
DOI:
https://doi.org/10.18203/2349-3291.ijcp20193741Keywords:
Adrenaline nebulization, Bronchiolitis, Hypertonic salineAbstract
Background: Bronchiolitis is the leading cause of acute illness and hospitalization in young children. There is limited role for diagnostic laboratory or radiographic tests in typical cases of bronchiolitis. Several large recent trials have revealed lack of efficacy of either bronchodilators or corticosteroids. Novel treatment like hypertonic saline and adrenaline nebulizations need to be evaluated for their efficacy.
Methods: In this retrospective case control study, we included children aged between 6 months to 2 years admitted for bronchiolitis between August 2017 till July 2018. Each of the 45 children treated with adrenaline nebulisation was assigned a child who was given hypertonic saline nebulization only matched for age and duration of symptoms.
Results: 45 children given adrenaline nebulization and 45 children given only hypertonic saline nebulization were compared. Mean duration of stay for children treated with adrenaline nebulization was 5.3 days and those given hypertonic saline was 4.8 days. p value of 0.29.
Conclusions: Adrenaline nebulization did not shorten hospital stay in children admitted for bronchiolitis as compared to children given hypertonic saline.
References
Glezen, WPTaber, LHFrank ALKasel, JA Risk of primary infection and reinfection with respiratory syncytial virus. AJDC, 1986;140(6):543-6.
Mansbach JM, Piedra PA, Teach SJ, Sullivan AF, Forgey T, Clark S, et al. Prospective multicenter study of viral etiology and hospital length of stay in children with severe bronchiolitis. Arch Pediatr Adolesc Med. 2012 Aug;166(8):700-6.
Diagnosis and management of bronchiolitis. Pediatrics. 2006 Oct;118(4):1774-93.
Knapp JF, Simon SD, Sharma V. Variation and trends in ED use of radiographs for asthma, bronchiolitis, and croup in children. Pediatrics. 2013 Aug;132(2):245-52.
Johnson LW, Robles J, Hudgins A, Osburn S, Martin D, Thompson A. Management of bronchiolitis in the emergency department: impact of evidence-based guidelines? Pediatr. 2013 Mar;131(1):S103-9.
Schuh S, Lalani A, Allen U, Manson D, Babyn P, Stephens D, et al. Evaluation of the utility of radiography in acute bronchiolitis. J Pediatr. 2007 Apr;150(4):429-33.
Meissner HC. Uncertainty in management of viral lower respiratory tract disease. Pediatris. 2001;108,1000-1003.
Ralston S, Garber M, Narang S, Shen M, Pate B, Pope J, et al. Decreasing unnecessary utilization in acute bronchiolitis care: results from the value in inpatient pediatrics network. J Hosp Med. 2013 Jan;8(1):25-30.
Zorc JJ, Hall CB. Bronchiolitis: recent evidence on diagnosis and management. Pediatr. 2010 Feb;125(2):342-9.
Hartling L, Bialy LM, Vandermeer B, Tjosvold L, Johnson DW, Plint AC, et al. Epinephrine for bronchiolitis. Cochrane Database Syst Rev. 2011;(6):CD003123.
Skjerven HO, Hunderi JO, Brugmann-Pieper SK, Brun AC, Engen H, Eskedal L, et al. Racemic adrenaline and inhalation strategies in acute bronchiolitis. N Engl J Med. 2013 Jun 13;368(24):2286-93.
Wright FH, Beem MO. Diagnosis and Treatment: Management of Acute Viral Bronchiolitis in Infancy. Pediatr. 1965 Feb;35:334-7.
Cochrane Library, Epinephrine for acute viral bronchiolitis in children less than two years of age. Available at https://www.cochrane.org/CD003123/ARI_epinephrine-for-acute-viral-bronchiolitis-in-children-less-than-two-years-of-age.
Maguire C, Cantrill H, Hind D. Hypertonic saline(HS) foracute bronchiolitis: systematic review and meta-analysis. BMC Pulm Med. 2015;15(1);148.
Gadomski AM, Scribani MB. Bronchodilators for bronchiolitis. Cochrane Database Syst. Rev. 2014;(6) CD001266.
Farley R Spurling GKP, Erikson L. Antibiotics for bronchiolitis in children under 2 years of age. Cochrane Database Syst. Rev 2014;CD005189.