Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Sep 14;20(1):434.
doi: 10.1186/s12887-020-02314-3.

Exploring the efficacy of using hypertonic saline for nebulizing treatment in children with bronchiolitis: a meta-analysis of randomized controlled trials

Chia-Wen Hsieh  1   2 , Chiehfeng Chen  3   4   5   6 , Hui-Chuan Su  1   2 , Kee-Hsin Chen  7   8   9   10
Affiliations
Meta-Analysis

Exploring the efficacy of using hypertonic saline for nebulizing treatment in children with bronchiolitis: a meta-analysis of randomized controlled trials

Chia-Wen Hsieh et al. BMC Pediatr. .

Abstract

Background: Inhaled hypertonic saline (HS) has shown benefit in decreasing airway edema in acute bronchiolitis which is the most common lower respiratory infection resulting in dyspnea among infants under 2 years old. The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of HS in the implementation of treatment with nebulized HS among children with bronchiolitis.

Methods: A systematic literature search was conducted using Cochrane Library, PubMed, EMBASE and Airiti Library (Chinese Database) for randomized controlled trials from inception to July 2019. We calculated pooled risk ratios (RR), mean difference (MD) and 95% CI using RevMan 5.3 for meta-analysis.

Results: There were 4186 children from 32 publications included. Compared to the control group, the HS group exhibited significant reduction of severity of respiratory distress, included studies used the Clinical Severity Score (n = 8; MD, - 0.71; 95% CI, - 1.15 to - 0.27; I2 = 73%) and full stop after Respiratory Distress Assessment Instrument (n = 5; MD, - 0.60; 95% CI, - 0.95 to - 0.26; I2 = 0%) for evaluation respectively. Further, the HS group decreased the length of hospital stay 0.54 days (n = 20; MD, - 0.54; 95% CI, - 0.86 to - 0.23; I2 = 81%).

Conclusions: We conclude that nebulization with 3% saline solution is effective in decreasing the length of hospital stay and the severity of symptoms as compared with 0.9% saline solution among children with acute bronchiolitis. Further rigorous randomized controlled trials with large sample size are needed.

Keywords: Bronchiolitis; Children; Efficacy; Hypertonic saline; Length of hospital stay; Nebulizer treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interests relevant to this article.

Figures

Fig. 1
Fig. 1
Flow diagram displaying the search process and search results
Fig. 2
Fig. 2
Risk of bias assessment for the included studies
Fig. 3
Fig. 3
Forest plot of the clinical severity score (CSS)
Fig. 4
Fig. 4
Forest plot of the Respiratory Distress Assessment Instrument (RDAI)
Fig. 5
Fig. 5
Forest plot of length of hospital stay (LOS)
Fig. 6
Fig. 6
Forest plot of the rate of hospitalization
Fig. 7
Fig. 7
Forest plot of the rate of readmission
Fig. 8
Fig. 8
Forest plot of time of sleeping
Fig. 9
Fig. 9
Forest plot of the frequency of waking up in the night
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Meissner HC. Selected populations at increased risk from respiratory syncytial virus infection. Pediatr Infect Dis J. 2003;22(2):S40–S45. - PubMed
    1. Shi T, McAllister DA, O'Brien KL, Simoes EA, Madhi SA, Gessner BD, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. Lancet. 2017;390(10098):946–958. - PMC - PubMed
    1. Chou T, Chen EY, Liu YY, Wu IP, Chien MY, Hsiao HF, Lai SH. A comparison study: Treat acute bronchiolitis infants with hypertonic saline by small volume jet nebulizer and portable vibrating-mesh nebulizer. In B57. PEDIATRIC INFECTION. American Thoracic Society. 2018. pp. A3685.
    1. Ozdogan S, Koker O, Kose G, Yildirmak Y. The efficacy of nebulized hypertonic saline in acute bronchiolitis in hospital setting: A randomized and double blind trial. In B32. VIRAL INFECTION OF THE AIRWAY. American Thoracic Society. 2014. pp. A2740.
    1. Jacques J, Bouscambert-Duchamp M, Moret H, Carquin J, Brodard V, Lina B, et al. Association of respiratory picornaviruses with acute bronchiolitis in French infants. J Clin Virol. 2006;35(4):463–466. - PubMed

Publication types

Substances

LinkOut - more resources