Home Current Archive Editorial Team
About us
Aims and scope About Author Guidelines
News Contact
×
Home Current Archive Editorial board

Aims and scope About Author Guidelines
News Contact
Review paper
Received: 16.11.2022. >> Accepted: 12.04.2023. >> Published: 01.12.2022. Biochemistry
<< Prev | Next >>
PDF
https://doi.org/10.17392/1560-23

Efficacy of nebulized hypertonic saline versus normal saline in the treatment of acute bronchiolitis in inpatient infants

By
Ganimeta Bakalović Orcid logo ,
Ganimeta Bakalović

Department of Pulmonology, Paediatric Clinic, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina

View authors publications

Search this author on:

PubMed | Google Scholar
Tarik Jarkoč ,
Tarik Jarkoč

Department of Pulmonology, Paediatric Clinic, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina

View authors publications

Search this author on:

PubMed | Google Scholar
Nedim Begić ,
Nedim Begić
Contact Nedim Begić

Department of Pulmonology, Paediatric Clinic, Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina

View authors publications

Search this author on:

PubMed | Google Scholar
Orhan Lepara ,
Orhan Lepara

School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina

View authors publications

Search this author on:

PubMed | Google Scholar
Dejan Bokonjić ,
Dejan Bokonjić

School of Medicine Foča, University of East Sarajevo, Foča, Bosnia and Herzegovina

View authors publications

Search this author on:

PubMed | Google Scholar
Dušan Mihajlović ,
Dušan Mihajlović

School of Medicine Foča, University of East Sarajevo, Foča, Bosnia and Herzegovina

View authors publications

Search this author on:

PubMed | Google Scholar
Amela Pasić ,
Amela Pasić

Department of Pulmonology and Cardiology, Clinic for Children Disease, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina

View authors publications

Search this author on:

PubMed | Google Scholar
Almir Fajkić
Almir Fajkić

School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina

View authors publications

Search this author on:

PubMed | Google Scholar

Abstract

Aim
Compare the efficacy of nebulized hypertonic saline and normal saline in the treatment of infants hospitalized for bronchiolitis.
Methods
This retrospective study was conducted at the Department of Pulmonology, Paediatric Clinic, Clinical Centre University of Sarajevo, covering the period from January 2015 to December 2019 and comprising 380 children aged between 1 and
12 months having bronchiolitis. One group received nebulized hypertonic saline (NHS, 3% NaCl)), and another group received nebulized normal saline (NNS, 0.9% NaCl). The control group did not receive any of these treatment options.
Results
There was no statistically significant difference between the treatment groups regarding length of hospital stay (LOS) and
Clinical Severity Score (CSS) at admission and discharge as well as in oxygen therapy duration and antibiotic use, the duration of symptoms before hospital admission, frequency of nasal discharge, elevated temperature, dyspnoea, cough and dehydration.
Conclusion
The results of this study are consistent with several recent studies or meta-analyses and support the evidence against the
use of NHS in hospitalized infants with mild or moderate bronchiolitis.

Keywords:

bronchioles,
infection,
therapy,
NaCl

References

1.
American Academy of Pediatrics Subcommittee on Diagnosis and Management of Bronchiolitis. Diagnosis and management of bronchiolitis. Pediatrics. 2006;118:1774–93.
2.
Florin TA, Plint AC, Zorc JJ. Viral bronchiolitis. Lancet. 2017;389:211–24.
3.
Megalaa R, Perez GF, Kilaikode-Cheruveettara S, Kotwal N, Rodriguez-Martinez CE, Nino G. Clinical definition of respiratory viral infections in young children and potential bronchiolitis misclassification. J Investig Med. 2018;66:46–51.
4.
Korppi M, Koponen P, Nuolivirta K. Upper age limit for bronchiolitis: 12 months or 6 months? Eur RespirJ. 2012;39:787–8.
5.
Boeck KD. Respiratory syncytial virus bronchiolitis: clinical aspects and epidemiology. Monaldi Arch Chest Dis. 1996;51:210–3.
6.
Tan J, Wu J, Jiang W, Huang L, Ji W, Yan Y, et al. Etiology, clinical characteristics and coinfection status of bronchiolitis in Suzhou. BMC Infect Dis. 2021;21(135).
7.
Ackermann MR. Lamb model of respiratory syncytial virus-associated lung disease: insights to pathogenesis and novel treatments. ILAR J. 2014;55:4–15.
8.
Smyth RL, Openshaw PJ. Bronchiolitis. Lancet. 2006;368:312–22.
9.
Barbati F, Moriondo M, Pisano L, Calistri E, Lodi L, Ricci S, et al. Epidemiology of respiratory syncytial virus-related hospitalization over a 5-year period in Italy: Evaluation of seasonality and age distribution before vaccine introduction. Vaccines (Basel. 2020;8(15).
10.
Colosia AD, Masaquel A, Hall CB, Barrett AM, Mahadevia PJ, Yogev R. Residential crowding and severe respiratory syncytial virus disease among infants and young children: a systematic literature review. BMC Infect Dis. 2012;12(95).
11.
Hernandez-Cancio S; American Academy of Pediatrics. Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis. Pediatrics. 2014;134:1474–502.
12.
Mandelberg A, Amirav I. Hypertonic saline or high volume normal saline for viral bronchiolitis: mechanisms and rationale. Pediatr Pulmonol. 2010;45:36–40.
13.
Angoulvant F, Bellêttre X, Milcent K, Teglas JP, Claudet I, Le Guen CG, et al. Efficacy of 3% Hypertonic Saline in Acute Viral Bronchiolitis (GUERANDE.
14.
M MDG, F S, S L, M C, B N, I C, et al. Effectiveness of nebulized hypertonic saline and epinephrine in hospitalized infants with bronchiolitis. Int J Immunopathol Pharmacol. 2012;25:485–91.
15.
Florin TA, Byczkowski T, Ruddy RM, Zorc JJ, Test M, Shah SS. Utilization of nebulized 3% saline in infants hospitalized with bronchiolitis. J Pediatr. 2015;166:1168–74.
16.
Mellick LB, Gonzalez J. The Problematic 2014 American Academy of Pediatrics Bronchiolitis Guidelines. Pediatr Emerg Care. 2019;35:654–8.
17.
Pandit P, Hoque MA, Pandit H, Dhar SK, Mondal D, Ahmad F. Efficacy of nebulized hypertonic saline (3%) versus normal saline and salbutamol in treating acute bronchiolitis in a tertiary hospital: a randomized controlled trial. Mymensingh Med J. 2022;31:295–303.
18.
Manti S, Staiano A, Orfeo L, Midulla F, Marseglia GL, Ghizzi C, et al. Italian guidelines on the management of bronchiolitis in infants. Ital J Pediatr. 2022;49(19).
19.
Ojha AR, Mathema S, Sah S, Aryal UR. A comparative study on use of 3% saline versus 0.9% saline nebulization in children with bronchiolitis. J Nepal Health Res Counc. 2014;12:39–43.
20.
Harrison W, Angoulvant F, House S, Gajdos V, Ralston SL. Hypertonic Saline in Bronchiolitis and Type I Error: A Trial Sequential Analysis. Pediatrics. 2018;142 20181144.
21.
Heikkilä P, Korppi M. Hypertonic saline in bronchiolitis: an updated meta-analysis. Arch Dis Child. 2021;106(102).
22.
Brever A, Tomat AM, Seghaye MC. Update on the management of bronchiolitis. Rev Med Liege. 2019;74:175–8.
23.
Midulla F, Petrarca L, Frassanito A, Mattia G, Zicari AM, Nenna R. Bronchiolitis clinics and medical treatment. Minerva Pediatr. 2018;70:600–11.
24.
Ouyang Y, Liao H, Hu Y, Luo K, Hu S, Zhu H. Innate Immune Evasion by Human Respiratory Syncytial Virus. Front Microbiol. 2022;13(865592).
25.
Köse S, Şehriyaroğlu A, Esen F, Özdemir A, Kardaş Z, Altuğ U, et al. Comparing the efficacy of 7%, 3% and 0.9% saline in moderate to severe bronchiolitis in infants. Balkan Med J. 2016;33:193–7.
26.
Sauvaget E, David M, Bresson V, Retornaz K, Bosdure E, Dubus JC. Nebulized hypertonic saline and acute viral bronchiolitis in infants: current aspects. Arch Pediatr. 2012;19:635–41.
27.
Al-Ansari K, Sakran M, Davidson BL, El Sayyed R, Mahjoub H, Ibrahim K. Nebulized 5% or 3% hypertonic or 0.9% saline for treating acute bronchiolitis in infants. J Pediatr. 2010;157(630–4):634 1.
28.
Jaquet-Pilloud R, Verga ME, Russo M, Gehri M, Pauchard JY. Nebulised hypertonic saline in moderateto-severe bronchiolitis: a randomised clinical trial. Arch Dis Child. 2020;105:236–40.
29.
Kanjanapradap T, Deerojanawong J, Sritippayawan S, Prapphal N. Does nebulized hypertonic saline shorten hospitalization in young children with acute viral wheezing? Pediatr Pulmonol. 2018;53:138–44.
30.
Zhang L, Mendoza-Sassi RA, Wainwright C, Klassen TP. Nebulised hypertonic saline solution for acute bronchiolitis in infants. Cochrane Database Syst Rev. 2017;12:CD006458.
31.
Heikkila P, Renko M, Korppi M. Hypertonic saline inhalations in bronchiolitis-A cumulative metaanalysis. Pediatr Pulmonol. 2018;53:233–42.
32.
Badgett RG, Vindhyal M, Stirnaman JT, Gibson CM, Halaby R. A living systematic review of nebulized hypertonic saline for acute bronchiolitis in infants. JAMA Pediatr. 2015;169:788–9.
33.
Korppi M. Therapeutic strategies for pediatric bronchiolitis. Expert Rev Respir Med. 2019;13(95).
34.
Yu JF, Zhang Y, Liu ZB, Wang J, Bai LP. 3% nebulized hypertonic saline versus normal saline for infants with acute bronchiolitis: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore. 2022;101:e31270.

Citation

Copyright

Authors retain copyright. This work is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons License

 

Article metrics

Google scholar: See link

{{ submission.title }}
Issue image
Vol 20, Issue 2, 2023
Morphometric analysis of clinically significant parameters of the main trunk of the left coronary artery Lung cancer screening in the healthcare system of Bosnia and Herzegovina Risk factors associated with the development of secondary hyperparathyroidism in dialysis patients The most common indications for measuring metanephrine and normetanephrine in plasma – a rational approach Correlation of the inclination of the tentorium cerebellum and the volume of the posterior cranial fossa See full issue

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.