Shawn Ralston1, Vanessa Hill, Marissa Martinez. 1. University of Texas Health Science Center at San Antonio, Department of Pediatrics, and Christus Santa Rosa Children's Hospital, 7703 Floyd Curl Dr, MSC 7829, San Antonio, TX 78229, USA. ralstons@uthscsa.edu
Abstract
OBJECTIVE: The goal was to determine an adverse event rate for nebulized hypertonic saline solution administered without adjunctive bronchodilators for infants with bronchiolitis. METHODS: This was a retrospective cohort study of the use of nebulized 3% saline for children<2 years of age who were hospitalized with the primary diagnosis of bronchiolitis at a single academic medical center. The medical records of study participants were analyzed for the use of nebulized 3% saline solution and any documented adverse events related to this therapy. Other clinical outcomes evaluated included respiratory distress scores, timing of the use of bronchodilators in relation to 3% saline solution, transfer to a higher level of care, and readmission within 72 hours after discharge. RESULTS: A total of 444 total doses of 3% saline solution were administered, with 377 doses (85%) being administered without adjunctive bronchodilators. Four adverse events occurred with these 377 doses, for a 1.0% adverse event rate (95% confidence interval: 0.3%-2.8%). Adverse events were generally mild. One episode of bronchospasm was documented, for a rate of 0.3% (95% confidence interval: <0.01%-1.6%). CONCLUSIONS: The use of 3% saline solution without adjunctive bronchodilators for inpatients with bronchiolitis had a low rate of adverse events in our center. Additional clinical trials of 3% saline solution in bronchiolitis should evaluate its effectiveness in the absence of adjunctive bronchodilators.
OBJECTIVE: The goal was to determine an adverse event rate for nebulized hypertonicsaline solution administered without adjunctive bronchodilators for infants with bronchiolitis. METHODS: This was a retrospective cohort study of the use of nebulized 3% saline for children<2 years of age who were hospitalized with the primary diagnosis of bronchiolitis at a single academic medical center. The medical records of study participants were analyzed for the use of nebulized 3% saline solution and any documented adverse events related to this therapy. Other clinical outcomes evaluated included respiratory distress scores, timing of the use of bronchodilators in relation to 3% saline solution, transfer to a higher level of care, and readmission within 72 hours after discharge. RESULTS: A total of 444 total doses of 3% saline solution were administered, with 377 doses (85%) being administered without adjunctive bronchodilators. Four adverse events occurred with these 377 doses, for a 1.0% adverse event rate (95% confidence interval: 0.3%-2.8%). Adverse events were generally mild. One episode of bronchospasm was documented, for a rate of 0.3% (95% confidence interval: <0.01%-1.6%). CONCLUSIONS: The use of 3% saline solution without adjunctive bronchodilators for inpatients with bronchiolitis had a low rate of adverse events in our center. Additional clinical trials of 3% saline solution in bronchiolitis should evaluate its effectiveness in the absence of adjunctive bronchodilators.
Authors: Eugenio Baraldi; Marcello Lanari; Paolo Manzoni; Giovanni A Rossi; Silvia Vandini; Alessandro Rimini; Costantino Romagnoli; Pierluigi Colonna; Andrea Biondi; Paolo Biban; Giampietro Chiamenti; Roberto Bernardini; Marina Picca; Marco Cappa; Giuseppe Magazzù; Carlo Catassi; Antonio Francesco Urbino; Luigi Memo; Gianpaolo Donzelli; Carlo Minetti; Francesco Paravati; Giuseppe Di Mauro; Filippo Festini; Susanna Esposito; Giovanni Corsello Journal: Ital J Pediatr Date: 2014-10-24 Impact factor: 2.638