The quality of evidence is downgraded by inconsistency (variability in results).
A Cochrane review [Abstract] 1 included 28 studies with a total of 4 195 infants with acute bronchiolitis (17 inpatient studies, n=2 028; 2 outpatient studies, n=194; 7 emergency department studies, n=1 873; 1 outpatient and emergency department study, n=100). The mean age of participants was from 2.6 to 12.5 months. Treatment regimens of nebulized hypertonic saline (volume, interval of administration, addition of bronchodilator, and treatment duration) varied across studies.
Hospitalized infants treated with nebulized hypertonic saline had shorter mean length of hospital stay (MD -0.41 days, 95% CI -0.75 to -0.07, statistical heterogeneity I² = 79%; 17 studies, n=1 867), and infants who received hypertonic saline also had lower post-inhalation clinical scores in the first 3 days of treatment (day 1: MD -0.77, 95% CI -1.18 to -0.36; day 2: MD -1.28, 95% CI -1.91 to -0.65; day 3: MD -1.43, 95% CI -1.82 to -1.04) compared to those treated with nebulized 0.9% saline. Nebulized hypertonic saline reduced the risk of hospitalization compared with nebulised 0.9% saline among infants who were outpatients and those treated in the emergency department (RR 0.86, 95% CI 0.76 to 0.98; 8 studies, n=1 723).Twenty-four studies presented safety data: 13 studies (n=1 363) did not report any adverse events, and 11 studies (n=2 360) reported at least one adverse event, most of which were mild and resolved spontaneously.
Primary/Secondary Keywords