Impact of hypertonic saline on hospitalization rate in infants with acute bronchiolitis: A meta‐analysis

  title={Impact of hypertonic saline on hospitalization rate in infants with acute bronchiolitis: A meta‐analysis},
  author={Linjie Zhang and Carlos B Gunther and Ozeias Sim{\~o}es Franco and Terry P Klassen},
  journal={Pediatric Pulmonology},
  pages={1089 - 1095}
This meta‐analysis aimed to assess the efficacy of nebulized hypertonic saline (HS) on the rate of hospitalization in infants with acute bronchiolitis in the Emergency Department (ED) setting. 

Effects of nebulized epinephrine in association with hypertonic saline for infants with acute bronchiolitis: A systematic review and meta‐analysis

Nebulized epinephrine and hypertonic saline have been extensively studied in infants with acute bronchiolitis, with conflicting results.

Exploring the appropriate dose of nebulized hypertonic saline for bronchiolitis: a dose–response meta-analysis

This study showed that nebulized HS is an effective and safe therapy for bronchiolitis and found that there was no significant difference between 3% HS and the higher doses (>3%) of HS in LOS and 24-hour CSS.

The cost-effectiveness of hypertonic saline inhalations for infant bronchiolitis

Evidence that nebulized 3% hypertonic solution was cost-effective in the inpatient treatment of infant bronchiolitis should be used by decision-makers to improve clinical practice guidelines and should be replicated to validate their results in other tropical countries.

Therapeutic strategies for pediatric bronchiolitis

  • M. Korppi
  • Medicine
    Expert review of respiratory medicine
  • 2019
This review focuses on the role of racemic epinephrine, systemic corticosteroids, hypertonic saline and high-flow oxygen therapy (HFOT) in the treatment of infants with bronchiolitis.

Acute Viral Bronchiolitis: A Narrative Review

The management of AVB remains a challenge, as the role of various interventions is not clear, and the routine administration of antibiotics, bronchodilators, corticosteroids, steam inhalation, chest physiotherapy, heliox, and antiviral drugs are not recommended.

Nebulized hypertonic saline 3% for 1 versus 3 days in hospitalized bronchiolitis: a blinded non-inferiority randomized controlled trial

Results seem not to be in favour of reducing the duration of nebulised HS treatment from 3 to 1 day in acute moderate bronchiolitis, with a non-significant tendency for less need of nutritional support and supplemental oxygen in HS3d group.

Pediatric Pulmonology year in review 2018: Asthma, physiology/pulmonary function testing, and respiratory infections

This review covers selected articles on asthma, physiology/lung function testing, and respiratory infections from Pediatric Pulmonology's major topic areas from 2018.


Pediatricians should be familiar with the updated, revised version of a previous 2006 AAP guideline on bronchiolitis as well as evidence behind available diagnostic and treatment modalities.



Effect of Nebulized Hypertonic Saline Treatment in Emergency Departments on the Hospitalization Rate for Acute Bronchiolitis: A Randomized Clinical Trial

Nebulized HS treatment did not significantly reduce the rate of hospital admissions among infants with a first episode of acute moderate to severe bronchiolitis who were admitted to the pediatric ED relative to NS, but mild adverse events were more frequent in the HS group.

Hypertonic Saline in Acute Bronchiolitis : A Randomized Controlled Trial

  • Medicine
  • 2013
In moderate to severe acute bronchiolitis, inhalation of 7% HS with epinephrine does not appear to confer any clinically significant decrease in BSS when compared with 0.9% saline with epinphrine.

7% Hypertonic Saline in Acute Bronchiolitis: A Randomized Controlled Trial

In moderate to severe acute bronchiolitis, inhalation of 7% HS with epinephrine does not appear to confer any clinically significant decrease in BSS when compared with 0.9% saline with epinphrine.

Nebulized hypertonic saline for bronchiolitis in the emergency department: a randomized clinical trial.

Infants with bronchiolitis and persistent respiratory distress after standard treatment in the emergency department had less improvement after receiving 3% HS compared with those who received NS, and administration of a single dose of3% HS does not appear to be indicated to treat bronchiolaitis in the acute care setting.

Effect of inhaled hypertonic saline on hospital admission rate in children with viral bronchiolitis: a randomized trial.

The short-term use of nebulized 3% HS did not result in any statistically significant benefits, although a nonsignificant trend toward a decrease in admission rate and improvement in respiratory distress was found.

SABRE: a multicentre randomised control trial of nebulised hypertonic saline in infants hospitalised with acute bronchiolitis

This study does not support the use of nebulised HS in the treatment of acute bronchiolitis over usual care with minimal handlings and no difference in adverse events.

Nebulized Hypertonic Saline for Acute Bronchiolitis: A Systematic Review

Nebulized HS is a safe and potentially effective treatment of infants with acute bronchiolitis and the quality of evidence is moderate due to inconsistency in results between trials and study limitations.

Maybe there is no such thing as bronchiolitis

  • B. Kuzik
  • Medicine
    Canadian Medical Association Journal
  • 2016
Physicians who have been in practice for 30 years or more have ridden the rollercoaster of optimism following the publication of randomized controlled trials aboutiral bronchiolitis.

Hypertonic saline inhalations in bronchiolitis—A cumulative meta‐analysis

In conclusion, HS inhalations offered only limited clinical benefits, though the differences between HS and control groups were statistically significant, and the heterogeneity between the studies was substantial.

Nebulized hypertonic saline for bronchiolitis: a randomized clinical trial.

Hypertonic saline given to children with bronchiolitis in the ED decreases hospital admissions and can detect no significant difference in Respiratory Distress Assessment Instrument score or length of stay between the HS and NS groups.