Hypertonic Saline for the Treatment of Bronchiolitis in Infants and Young Children: A Critical Review of the Literature
Bronchiolitis, an infection of the lower respiratory tract, is the leading cause of infant and child hospitalization in the United States. Therapeutic options for management of bronchiolitis are limited. Hypertonic saline inhalation therapy has been studied in numerous clinical trials with mixed res...
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| Published in | The journal of pediatric pharmacology and therapeutics Vol. 21; no. 1; pp. 7 - 26 |
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| Main Authors | , |
| Format | Journal Article |
| Language | English |
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United States
Pediatric Pharmacy Advocacy Group
01.01.2016
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| Abstract | Bronchiolitis, an infection of the lower respiratory tract, is the leading cause of infant and child hospitalization in the United States. Therapeutic options for management of bronchiolitis are limited. Hypertonic saline inhalation therapy has been studied in numerous clinical trials with mixed results. In 2014, the American Academy of Pediatrics (AAP) published updated guidelines on the diagnosis and management of bronchiolitis, which include new recommendations on the use of hypertonic saline. We reviewed all published clinical trials mentioned in the 2014 AAP guidelines, as well as additional trials published since the guidelines, and critically evaluated each trial to determine efficacy, safety, and expectations of hypertonic saline inhalation therapy. A total of 2682 infants were studied over the course of 22 clinical trials. Nine trials were carried out in the outpatient/clinic/emergency department and 13 in the inpatient setting. We agree with the AAP guidelines regarding the recommendation to use nebulized hypertonic saline for infants hospitalized with bronchiolitis, with the expectation of reducing bronchiolitis scores and length of stay when it is expected to last more than 72 hours. However, we also believe there might be an advantage for hypertonic saline in reducing admission rates from the emergency department, based on close examination of the results of recent trials. This review also highlights important gaps in the available literature that need to be addressed in order to define the role of inhaled hypertonic saline therapy. |
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| AbstractList | Bronchiolitis, an infection of the lower respiratory tract, is the leading cause of infant and child hospitalization in the United States. Therapeutic options for management of bronchiolitis are limited. Hypertonic saline inhalation therapy has been studied in numerous clinical trials with mixed results. In 2014, the American Academy of Pediatrics (AAP) published updated guidelines on the diagnosis and management of bronchiolitis, which include new recommendations on the use of hypertonic saline. We reviewed all published clinical trials mentioned in the 2014 AAP guidelines, as well as additional trials published since the guidelines, and critically evaluated each trial to determine efficacy, safety, and expectations of hypertonic saline inhalation therapy. A total of 2682 infants were studied over the course of 22 clinical trials. Nine trials were carried out in the outpatient/clinic/emergency department and 13 in the inpatient setting. We agree with the AAP guidelines regarding the recommendation to use nebulized hypertonic saline for infants hospitalized with bronchiolitis, with the expectation of reducing bronchiolitis scores and length of stay when it is expected to last more than 72 hours. However, we also believe there might be an advantage for hypertonic saline in reducing admission rates from the emergency department, based on close examination of the results of recent trials. This review also highlights important gaps in the available literature that need to be addressed in order to define the role of inhaled hypertonic saline therapy. |
| Author | Baron, Jeffrey El-Chaar, Gladys |
| Author_xml | – sequence: 1 givenname: Jeffrey surname: Baron fullname: Baron, Jeffrey organization: Pharmacy Department, Roswell Park Cancer Institute, Buffalo, New York – sequence: 2 givenname: Gladys surname: El-Chaar fullname: El-Chaar, Gladys organization: Pharmacy Department, Roswell Park Cancer Institute, Buffalo, New York ; Department of Pharmacy, Winthrop-University Hospital, Mineola, New York ; Department of Clinical Pharmacy Practice, St John's University College of Pharmacy and Health Sciences, Jamaica, New York |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26997926$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1136/bmj.d1714 10.1097/01.inf.0000069765.43405.3b 10.1001/jamapediatrics.2013.5306 10.1136/archdischild-2013-305443 10.1056/NEJMoa022226 10.1007/s13312-013-0216-8 10.1056/NEJMoa1301839 10.1111/j.1469-0691.2010.03304.x 10.1016/j.jpeds.2010.04.074 10.1001/archpediatrics.2009.196 10.1542/peds.100.2.233 10.1111/j.1442-200X.2009.02941.x 10.1016/j.pupt.2005.03.002 10.1001/archpedi.157.10.957 10.1177/039463201202500218 10.1542/peds.79.6.939 10.1136/thoraxjnl-2014-205953 10.1001/jamapediatrics.2014.301 10.1183/09031936.00159613 10.1542/pir.35-12-519 10.1016/j.pupt.2011.09.004 10.1164/rccm.200204-293OC 10.1007/s12325-010-0076-8 10.1016/j.prrv.2009.10.001 10.1136/adc.2008.153361 10.1378/chest.122.6.2015 10.1017/S1481803500012690 10.1164/ajrccm/145.1.106 10.1001/archpedi.1996.02170360056009 10.1002/ppul.21108 10.1378/chest.123.2.481 10.1001/archpedi.158.2.127 10.1542/peds.2012-3877 10.1542/peds.2013-1646 10.1002/ppul.22935 10.1016/j.jpeds.2015.01.045 10.1542/peds.2014-2742 10.1183/09031936.96.09040725 10.1067/mpd.2003.196 10.1002/ppul.21185 |
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| Copyright | 2016 Pediatric Pharmacy Advocacy Group 2016 |
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| References | 14757604 - Arch Pediatr Adolesc Med. 2004 Feb;158(2):127-37 24574431 - Pediatr Pulmonol. 2014 Sep;49(9):919-25 14557155 - Arch Pediatr Adolesc Med. 2003 Oct;157(10):957-64 23733801 - Pediatrics. 2013 Jul;132(1):28-36 20113991 - Paediatr Respir Rev. 2010 Mar;11(1):39-45; quiz 45 1731571 - Am Rev Respir Dis. 1992 Jan;145(1):106-9 19953579 - Pediatr Pulmonol. 2010 Jan;45(1):41-7 23502662 - Indian Pediatr. 2013 Aug;50(8):743-7 21978929 - Pulm Pharmacol Ther. 2011 Dec;24(6):633-7 12475841 - Chest. 2002 Dec;122(6):2015-20 19822538 - Arch Dis Child. 2010 Jan;95(1):35-41 12799502 - Pediatr Infect Dis J. 2003 Jun;22(6):483-90 20953746 - Adv Ther. 2010 Nov;27(11):870-8 20014350 - Pediatr Pulmonol. 2010 Jan;45(1):36-40 23758233 - N Engl J Med. 2013 Jun 13;368(24):2286-93 24521787 - Arch Dis Child. 2014 Jun;99(6):511-5 12411282 - Am J Respir Crit Care Med. 2003 Jan 15;167(2):158-63 20646715 - J Pediatr. 2010 Oct;157(4):630-4, 634.e1 12756382 - J Pediatr. 2003 May;142(5):509-14 19370568 - Cochrane Database Syst Rev. 2009 Apr 15;(2):CD001506 21073773 - CJEM. 2010 Nov;12(6):477-84 16599051 - Isr Med Assoc J. 2006 Mar;8(3):169-73 19884591 - Arch Pediatr Adolesc Med. 2009 Nov;163(11):1007-12 25747800 - J Pediatr. 2015 May;166(5):1168-1174.e2 24862342 - JAMA Pediatr. 2014 Jul;168(7):664-70 8904857 - Arch Pediatr Adolesc Med. 1996 Nov;150(11):1166-72 24969648 - Eur Respir J. 2014 Oct;44(4):913-21 12137663 - Cochrane Database Syst Rev. 2002;(3):CD002873 22697080 - Int J Immunopathol Pharmacol. 2012 Apr-Jun;25(2):485-91 11578545 - An Esp Pediatr. 2001 Oct;55(4):355-64 8726937 - Eur Respir J. 1996 Apr;9(4):725-32 25452661 - Pediatr Rev. 2014 Dec;35(12):519-30 21471175 - BMJ. 2011 Apr 06;342:d1714 24344111 - Pediatrics. 2014 Jan;133(1):e8-13 23733383 - Cochrane Database Syst Rev. 2013 Jun 04;(6):CD004878 24937099 - Cochrane Database Syst Rev. 2014 Jun 17;(6):CD001266 23900970 - Cochrane Database Syst Rev. 2013 Jul 31;(7):CD006458 25349312 - Pediatrics. 2014 Nov;134(5):e1474-502 12840089 - N Engl J Med. 2003 Jul 3;349(1):27-35 25263242 - Minerva Pediatr. 2016 Apr;68(2):81-8 16406721 - Pulm Pharmacol Ther. 2006;19(3):166-71 19674354 - Pediatr Int. 2010 Apr;52(2):199-202 3295741 - Pediatrics. 1987 Jun;79(6):939-45 9240805 - Pediatrics. 1997 Aug;100(2 Pt 1):233-9 24862623 - JAMA Pediatr. 2014 Jul;168(7):657-63 25389139 - Thorax. 2014 Dec;69(12):1105-12 25574983 - J Nepal Health Res Counc. 2014 Jan;12(26):39-43 12576370 - Chest. 2003 Feb;123(2):481-7 20636429 - Clin Microbiol Infect. 2011 Dec;17(12):1829-33 Teunissen (2020102715422426100_i1551-6776-21-1-7-b47) 2014; 44 Petrigni (2020102715422426100_i1551-6776-21-1-7-b43) 2006; 19 Midulla (2020102715422426100_i1551-6776-21-1-7-b45) 2010; 95 Wainwright (2020102715422426100_i1551-6776-21-1-7-b15) 2003; 349 Ojha (2020102715422426100_i1551-6776-21-1-7-b46) 2014; 12 Holman (2020102715422426100_i1551-6776-21-1-7-b4) 2003; 22 Tal (2020102715422426100_i1551-6776-21-1-7-b33) 2006; 8 Wark (2020102715422426100_i1551-6776-21-1-7-b20) 2009; 2 Luo (2020102715422426100_i1551-6776-21-1-7-b35) 2011; 17 Luo (2020102715422426100_i1551-6776-21-1-7-b34) 2010; 52 Daviskas (2020102715422426100_i1551-6776-21-1-7-b17) 1996; 9 Wainwright (2020102715422426100_i1551-6776-21-1-7-b10) 2010; 11 Chavasse (2020102715422426100_i1551-6776-21-1-7-b5) 2002; 3 Buonpensiero (2020102715422426100_i1551-6776-21-1-7-b44) 2010; 27 Ipek (2020102715422426100_i1551-6776-21-1-7-b28) 2011; 24 Kuzik (2020102715422426100_i1551-6776-21-1-7-b27) 2010; 12 Hartling (2020102715422426100_i1551-6776-21-1-7-b11) 2011; 342 Fernandes (2020102715422426100_i1551-6776-21-1-7-b16) 2013; 6 Sharma (2020102715422426100_i1551-6776-21-1-7-b37) 2013; 50 Miraglia Del Giudice (2020102715422426100_i1551-6776-21-1-7-b36) 2012; 25 Flores-Gonzalez (2020102715422426100_i1551-6776-21-1-7-b40) 2014 Gadomski (2020102715422426100_i1551-6776-21-1-7-b7) 2014; 6 Sood (2020102715422426100_i1551-6776-21-1-7-b19) 2003; 167 Sarrell (2020102715422426100_i1551-6776-21-1-7-b21) 2002; 122 Piedimonte (2020102715422426100_i1551-6776-21-1-7-b3) 2014; 35 Wang (2020102715422426100_i1551-6776-21-1-7-b22) 1992; 145 Skjerven (2020102715422426100_i1551-6776-21-1-7-b14) 2013; 368 Florin (2020102715422426100_i1551-6776-21-1-7-b29) 2014; 168 Flores (2020102715422426100_i1551-6776-21-1-7-b6) 1997; 100 Bueno Campaña (2020102715422426100_i1551-6776-21-1-7-b38) 2014; 99 Jacobs (2020102715422426100_i1551-6776-21-1-7-b30) 2014; 133 Hasegawa (2020102715422426100_i1551-6776-21-1-7-b2) 2013; 132 Patel (2020102715422426100_i1551-6776-21-1-7-b13) 2003; 142 Grewal (2020102715422426100_i1551-6776-21-1-7-b23) 2009; 163 Wu (2020102715422426100_i1551-6776-21-1-7-b31) 2014; 168 Kellner (2020102715422426100_i1551-6776-21-1-7-b8) 1996; 150 Nenna (2020102715422426100_i1551-6776-21-1-7-b42) 2014; 49 Lowell (2020102715422426100_i1551-6776-21-1-7-b24) 1987; 79 Al-Ansari (2020102715422426100_i1551-6776-21-1-7-b25) 2010; 157 Zhang (2020102715422426100_i1551-6776-21-1-7-b49) 2013; 7 Florin (2020102715422426100_i1551-6776-21-1-7-b48) 2015; 166 Gonzalez Caballero (2020102715422426100_i1551-6776-21-1-7-b41) 2001; 55 Ralston (2020102715422426100_i1551-6776-21-1-7-b1) 2014; 134 King (2020102715422426100_i1551-6776-21-1-7-b9) 2004; 158 Hartling (2020102715422426100_i1551-6776-21-1-7-b12) 2003; 157 Everard (2020102715422426100_i1551-6776-21-1-7-b39) 2014; 69 Mandelberg (2020102715422426100_i1551-6776-21-1-7-b18) 2010; 45 Anil (2020102715422426100_i1551-6776-21-1-7-b26) 2010; 45 Mandelberg (2020102715422426100_i1551-6776-21-1-7-b32) 2003; 123 |
| References_xml | – volume: 342 start-page: d1714 year: 2011 ident: 2020102715422426100_i1551-6776-21-1-7-b11 article-title: Steroids and bronchodilators for acute bronchiolitis in the first two years of life: systematic review and meta-analysis publication-title: BMJ doi: 10.1136/bmj.d1714 contributor: fullname: Hartling – volume: 22 start-page: 483 issue: 6 year: 2003 ident: 2020102715422426100_i1551-6776-21-1-7-b4 article-title: Risk factors for bronchiolitis-associated deaths among infants in the United States publication-title: Pediatr Infect Dis J doi: 10.1097/01.inf.0000069765.43405.3b contributor: fullname: Holman – volume: 168 start-page: 664 issue: 7 year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b29 article-title: Nebulized hypertonic saline for bronchiolitis in the emergency department: a randomized clinical trial publication-title: JAMA Pediatr doi: 10.1001/jamapediatrics.2013.5306 contributor: fullname: Florin – volume: 99 start-page: 511 issue: 6 year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b38 article-title: High flow therapy versus hypertonic saline in bronchiolitis: randomised controlled trial publication-title: Arch Dis Child doi: 10.1136/archdischild-2013-305443 contributor: fullname: Bueno Campaña – volume: 55 start-page: 355 issue: 4 year: 2001 ident: 2020102715422426100_i1551-6776-21-1-7-b41 article-title: Acute bronchiolitis: fundamentals of a rational protocol publication-title: Ann Esp Pediatr contributor: fullname: Gonzalez Caballero – volume: 349 start-page: 27 issue: 1 year: 2003 ident: 2020102715422426100_i1551-6776-21-1-7-b15 article-title: A multicenter, randomized, double-blind, controlled trial of nebulized epinephrine in infants with acute bronchiolitis publication-title: N Engl J Med doi: 10.1056/NEJMoa022226 contributor: fullname: Wainwright – volume: 50 start-page: 743 issue: 8 year: 2013 ident: 2020102715422426100_i1551-6776-21-1-7-b37 article-title: Hypertonic (3%) saline vs 0.93% saline nebulization for acute viral bronchiolitis: a randomized controlled trial publication-title: Indian Pediatr doi: 10.1007/s13312-013-0216-8 contributor: fullname: Sharma – volume: 368 start-page: 2286 issue: 24 year: 2013 ident: 2020102715422426100_i1551-6776-21-1-7-b14 article-title: Racemic adrenaline and inhalation strategies in acute bronchiolitis publication-title: N Engl J Med doi: 10.1056/NEJMoa1301839 contributor: fullname: Skjerven – volume: 17 start-page: 1829 issue: 12 year: 2011 ident: 2020102715422426100_i1551-6776-21-1-7-b35 article-title: Nebulized hypertonic saline treatment in hospitalized children with moderate to severe viral bronchiolitis publication-title: Clin Microbiol Infect doi: 10.1111/j.1469-0691.2010.03304.x contributor: fullname: Luo – volume: 157 start-page: 630 issue: 4 year: 2010 ident: 2020102715422426100_i1551-6776-21-1-7-b25 article-title: Nebulized 5% or 3% hypertonic or 0.9% saline for treating acute bronchiolitis in infants publication-title: J Pediatr doi: 10.1016/j.jpeds.2010.04.074 contributor: fullname: Al-Ansari – volume: 163 start-page: 1007 issue: 11 year: 2009 ident: 2020102715422426100_i1551-6776-21-1-7-b23 article-title: A randomized trial of nebulized 3% hypertonic saline with epinephrine in the treatment of acute bronchiolitis in the emergency department publication-title: Arch Pediatr Adolesc Med doi: 10.1001/archpediatrics.2009.196 contributor: fullname: Grewal – volume: 100 start-page: 233 issue: 2 Pt 1 year: 1997 ident: 2020102715422426100_i1551-6776-21-1-7-b6 article-title: Efficacy of beta2-agonists in bronchiolitis: a reappraisal and meta-analysis publication-title: Pediatrics doi: 10.1542/peds.100.2.233 contributor: fullname: Flores – volume: 52 start-page: 199 issue: 2 year: 2010 ident: 2020102715422426100_i1551-6776-21-1-7-b34 article-title: Nebulized hypertonic saline/salbutamol solution treatment in hospitalized children with mild to moderate bronchiolitis publication-title: Pediatr Int doi: 10.1111/j.1442-200X.2009.02941.x contributor: fullname: Luo – volume: 19 start-page: 166 issue: 3 year: 2006 ident: 2020102715422426100_i1551-6776-21-1-7-b43 article-title: Aerosolised hyaluronic acid prevents exercise-induced bronchoconstriction, suggesting novel hypotheses on the correction of matrix defects in asthma publication-title: Pulm Pharmacol Ther doi: 10.1016/j.pupt.2005.03.002 contributor: fullname: Petrigni – volume: 157 start-page: 957 issue: 10 year: 2003 ident: 2020102715422426100_i1551-6776-21-1-7-b12 article-title: A meta-analysis of randomized controlled trials evaluating the efficacy of epinephrine for the treatment of acute viral bronchiolitis publication-title: Arch Pediatr Adolesc Med doi: 10.1001/archpedi.157.10.957 contributor: fullname: Hartling – volume: 8 start-page: 169 issue: 3 year: 2006 ident: 2020102715422426100_i1551-6776-21-1-7-b33 article-title: Hypertonic saline/epinephrine treatment in hospitalized infants with viral bronchiolitis reduces hospitalization stay: 2 years' experience publication-title: Isr Med Assoc J contributor: fullname: Tal – volume: 25 start-page: 485 issue: 2 year: 2012 ident: 2020102715422426100_i1551-6776-21-1-7-b36 article-title: Effectiveness of nebulized hypertonic saline and epinephrine in hospitalized infants with bronchiolitis publication-title: Int J Immunopathol Pharmacol doi: 10.1177/039463201202500218 contributor: fullname: Miraglia Del Giudice – volume: 79 start-page: 939 issue: 6 year: 1987 ident: 2020102715422426100_i1551-6776-21-1-7-b24 article-title: Wheezing in infants: the response to epinephrine publication-title: Pediatrics doi: 10.1542/peds.79.6.939 contributor: fullname: Lowell – volume: 69 start-page: 1105 issue: 12 year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b39 article-title: SABRE: a multicentre randomised control trial of nebulised hypertonic saline in infants hospitalised with acute bronchiolitis publication-title: Thorax doi: 10.1136/thoraxjnl-2014-205953 contributor: fullname: Everard – volume: 168 start-page: 657 issue: 7 year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b31 article-title: Nebulized hypertonic saline for bronchiolitis: a randomized clinical trial publication-title: JAMA Pediatr doi: 10.1001/jamapediatrics.2014.301 contributor: fullname: Wu – volume: 44 start-page: 913 issue: 4 year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b47 article-title: The effect of 3% and 6% hypertonic saline in viral bronchiolitis: a randomised controlled trial publication-title: Eur Respir J doi: 10.1183/09031936.00159613 contributor: fullname: Teunissen – volume: 35 start-page: 519 issue: 12 year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b3 article-title: Respiratory syncytial virus infection and bronchiolitis publication-title: Pediatr Rev doi: 10.1542/pir.35-12-519 contributor: fullname: Piedimonte – volume: 2 start-page: CD001506 year: 2009 ident: 2020102715422426100_i1551-6776-21-1-7-b20 article-title: Nebulised hypertonic saline for cystic fibrosis publication-title: Cochrane Database Syst Rev contributor: fullname: Wark – volume: 24 start-page: 633 issue: 6 year: 2011 ident: 2020102715422426100_i1551-6776-21-1-7-b28 article-title: The efficacy of nebulized salbutamol, hypertonic saline and salbutamol/hypertonic saline combination in moderate bronchiolitis publication-title: Pulm Pharmacol Ther doi: 10.1016/j.pupt.2011.09.004 contributor: fullname: Ipek – volume: 167 start-page: 158 issue: 2 year: 2003 ident: 2020102715422426100_i1551-6776-21-1-7-b19 article-title: Increasing concentration of inhaled saline with or without amiloride: effect on mucociliary clearance in normal subjects publication-title: Am J Respir Crit Care Med doi: 10.1164/rccm.200204-293OC contributor: fullname: Sood – volume: 3 start-page: CD002873 year: 2002 ident: 2020102715422426100_i1551-6776-21-1-7-b5 article-title: Short acting beta agonists for recurrent wheeze in children under 2 years of age publication-title: Cochrane Database Syst Rev contributor: fullname: Chavasse – volume: 27 start-page: 870 issue: 11 year: 2010 ident: 2020102715422426100_i1551-6776-21-1-7-b44 article-title: Hyaluronic acid improves “pleasantness” and tolerability of nebulized hypertonic saline in a cohort of patients with cystic fibrosis publication-title: Adv Ther doi: 10.1007/s12325-010-0076-8 contributor: fullname: Buonpensiero – volume: 11 start-page: 39 issue: 1 year: 2010 ident: 2020102715422426100_i1551-6776-21-1-7-b10 article-title: Acute viral bronchiolitis in children—a very common condition with few therapeutic options publication-title: Paediatr Respir Rev doi: 10.1016/j.prrv.2009.10.001 contributor: fullname: Wainwright – volume: 95 start-page: 35 issue: 1 year: 2010 ident: 2020102715422426100_i1551-6776-21-1-7-b45 article-title: Respiratory syncytial virus, human bocavirus and rhinovirus bronchiolitis in infants publication-title: Arch Dis Child doi: 10.1136/adc.2008.153361 contributor: fullname: Midulla – volume: 122 start-page: 2015 issue: 6 year: 2002 ident: 2020102715422426100_i1551-6776-21-1-7-b21 article-title: Nebulized 3% hypertonic saline solution treatment in ambulatory children with viral bronchiolitis decreases symptoms publication-title: Chest doi: 10.1378/chest.122.6.2015 contributor: fullname: Sarrell – volume: 12 start-page: 477 issue: 6 year: 2010 ident: 2020102715422426100_i1551-6776-21-1-7-b27 article-title: Effect of inhaled hypertonic saline on hospital admission rate in children with viral bronchiolitis: a randomized trial publication-title: CJEM doi: 10.1017/S1481803500012690 contributor: fullname: Kuzik – volume: 145 start-page: 106 issue: 1 year: 1992 ident: 2020102715422426100_i1551-6776-21-1-7-b22 article-title: Observer agreement for respiratory signs and oximetry in infants hospitalized with lower respiratory infections publication-title: Am Rev Respir Dis doi: 10.1164/ajrccm/145.1.106 contributor: fullname: Wang – volume: 150 start-page: 1166 issue: 11 year: 1996 ident: 2020102715422426100_i1551-6776-21-1-7-b8 article-title: Efficacy of bronchodilator therapy in bronchiolitis. A meta-analysis publication-title: Arch Pediatr Adolesc Med doi: 10.1001/archpedi.1996.02170360056009 contributor: fullname: Kellner – volume: 45 start-page: 41 issue: 1 year: 2010 ident: 2020102715422426100_i1551-6776-21-1-7-b26 article-title: High volume normal saline alone is as effective as nebulized salbutamol-normal saline, epinephrine-normal saline, and 3% saline in mild bronchiolitis publication-title: Pediatr Pulmonol doi: 10.1002/ppul.21108 contributor: fullname: Anil – volume: 123 start-page: 481 issue: 2 year: 2003 ident: 2020102715422426100_i1551-6776-21-1-7-b32 article-title: Nebulized 3% hypertonic saline solution treatment in hospitalized infants with viral bronchiolitis publication-title: Chest doi: 10.1378/chest.123.2.481 contributor: fullname: Mandelberg – volume: 158 start-page: 127 issue: 2 year: 2004 ident: 2020102715422426100_i1551-6776-21-1-7-b9 article-title: Pharmacologic treatment of bronchiolitis in infants and children: a systematic review publication-title: Arch Pediatr Adolesc Med doi: 10.1001/archpedi.158.2.127 contributor: fullname: King – volume: 7 start-page: CD006458 year: 2013 ident: 2020102715422426100_i1551-6776-21-1-7-b49 article-title: Nebulised hypertonic saline solution for acute bronchiolitis in infants publication-title: Cochrane Database Syst Rev contributor: fullname: Zhang – volume: 132 start-page: 28 issue: 1 year: 2013 ident: 2020102715422426100_i1551-6776-21-1-7-b2 article-title: Trends in bronchiolitis hospitalizations in the United States, 2000–2009 publication-title: Pediatrics doi: 10.1542/peds.2012-3877 contributor: fullname: Hasegawa – volume: 133 start-page: e8 issue: 1 year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b30 article-title: 7% Hypertonic saline in acute bronchiolitis: a randomized controlled trial publication-title: Pediatrics doi: 10.1542/peds.2013-1646 contributor: fullname: Jacobs – volume: 12 start-page: 39 issue: 26 year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b46 article-title: A comparative study on use of 3% saline versus 0.9% saline nebulization in children with bronchiolitis publication-title: J Nepal Health Res Counc contributor: fullname: Ojha – volume: 49 start-page: 919 issue: 9 year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b42 article-title: Seven percent hypertonic saline—0.1% hyaluronic acid in infants with mild-to-moderate bronchiolitis publication-title: Pediatr Pulmonol doi: 10.1002/ppul.22935 contributor: fullname: Nenna – volume: 166 start-page: 1168 issue: 5 year: 2015 ident: 2020102715422426100_i1551-6776-21-1-7-b48 article-title: Utilization of nebulized 3% saline in infants hospitalized with bronchiolitis publication-title: J Pediatr doi: 10.1016/j.jpeds.2015.01.045 contributor: fullname: Florin – volume: 6 start-page: CD001266 year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b7 article-title: Bronchodilators for bronchiolitis publication-title: Cochrane Database Syst Rev contributor: fullname: Gadomski – volume: 134 start-page: e1474 issue: 5 year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b1 article-title: Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis publication-title: Pediatrics doi: 10.1542/peds.2014-2742 contributor: fullname: Ralston – volume: 9 start-page: 725 issue: 4 year: 1996 ident: 2020102715422426100_i1551-6776-21-1-7-b17 article-title: Inhalation of hypertonic saline aerosol enhances mucociliary clearance in asthmatic and healthy subjects publication-title: Eur Respir J doi: 10.1183/09031936.96.09040725 contributor: fullname: Daviskas – volume: 142 start-page: 509 issue: 5 year: 2003 ident: 2020102715422426100_i1551-6776-21-1-7-b13 article-title: Randomized, double-blind, placebo-controlled trial of oral albuterol in infants with mild-to-moderate acute viral bronchiolitis publication-title: J Pediatr doi: 10.1067/mpd.2003.196 contributor: fullname: Patel – year: 2014 ident: 2020102715422426100_i1551-6776-21-1-7-b40 article-title: Does nebulized epinephrine improve the efficacy of hypertonic saline solution in the treatment of hospitalized moderate acute bronchiolitis? A double blind, randomized clinical trial publication-title: Minerva Pediatr contributor: fullname: Flores-Gonzalez – volume: 45 start-page: 36 issue: 1 year: 2010 ident: 2020102715422426100_i1551-6776-21-1-7-b18 article-title: Hypertonic saline or high volume normal saline for viral bronchiolitis: mechanisms and rationale publication-title: Pediatr Pulmonol doi: 10.1002/ppul.21185 contributor: fullname: Mandelberg – volume: 6 start-page: CD004878 year: 2013 ident: 2020102715422426100_i1551-6776-21-1-7-b16 article-title: Glucocorticoids for acute viral bronchiolitis in infants and young children publication-title: Cochrane Database Syst Rev contributor: fullname: Fernandes |
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