Evidence map›Paper›PMID 18843717›Full record

SynthesisThe Cochrane database of systematic reviews2008

Nebulized hypertonic saline solution for acute bronchiolitis in infants.

Linjie Zhang, Raúl A Mendoza-Sassi, Claire Wainwright, Terry P Klassen

4 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 32 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01238848 nacompletednot on this mapstarted 2010, after this paper: background citation

A Randomized Controlled Trial to Evaluate Efficacy of Nebulized Hypertonic Saline vs. Normal Saline in the Treatment of Hospitalized Children With Bronchiolitis

TypeinterventionalSponsorHospital General de Niños Pedro de ElizaldeRan2010 to 2012Enrolled82ConditionsBronchiolitisArmsHypertonic saline, Normal saline
NCT01247064 phase4completednot on this mapstarted 2010, after this paper: background citation

Nebulized Hypertonic Saline for Acute Bronchiolitis in the Emergency Department

TypeinterventionalSponsorChildren's Hospital of PhiladelphiaRan2010 to 2011Enrolled62ConditionsBronchiolitis, Viral, Saline Solution, HypertonicArmsNebulized 3% saline, Nebulized 0.9% Normal Saline
NCT01945944 phase1 / phase2completednot on this mapstarted 2013, after this paper: background citation

Nebulized Hypertonic Saline for Mechanically Ventilated Children

TypeinterventionalSponsorUniversity Hospitals Cleveland Medical CenterRan2013 to 2014Enrolled18ConditionsRespiratory FailureArmsHypertonic saline (3%), Placebo (0.9% saline)
NCT02834819 naterminatednot on this mapstarted 2013, after this paper: background citation

A Randomized Controlled Trial of Nebulized 3% Hypertonic Saline vs. Standard of Care in Patients With Bronchiolitis

TypeinterventionalSponsorUniversity of Colorado, DenverRan2013 to 2015Enrolled18ConditionsBronchiolitisArms3% Nebulized Hypertonic Saline
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 5 syntheses or guidelines pooled it, 207 citations in OpenAlex.

  1. Nebulised hypertonic saline solution for acute bronchiolitis in infants.The Cochrane database of systematic reviews · 2017
    Pooled it
  2. Pooled it
  3. Glucocorticoids for acute viral bronchiolitis in infants and young children.The Cochrane database of systematic reviews · 2013
    Pooled it
  4. Pooled it
  5. Epinephrine for bronchiolitis.The Cochrane database of systematic reviews · 2011
    Pooled it
  6. Trial
  7. Review
  8. Improving Evidence Based Bronchiolitis Care.Clinical pediatric emergency medicine · 2018
    Article
  9. Maybe there is no such thing as bronchiolitis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2016
    Review
  10. Management of Respiratory Syncytial Virus Bronchiolitis: 2015 Survey of Members of the European Society for Paediatric Infectious Diseases.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2016
    Article
  11. [Respiratory emergencies and airway management in children].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2015
    Review
  12. Article
  13. Article
  14. Article
  15. Review
  16. Review
  17. Article
  18. Article
  19. Article
  20. Common pediatric respiratory emergencies.Emergency medicine clinics of North America · 2012
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 4 countries.

Linjie ZhangDepartment of Maternal and Child Health, Federal University of Rio Grande, Rua Visconde Paranaguá 102, Centro, Rio Grande, RS, Brazil, 96201-900. zhanglinjie63@yahoo.com.br
Raúl A Mendoza-Sassi
Claire Wainwright
Terry P Klassen
Children's Hospital Research Institute of Manitoba · CARoyal Children's Hospital · AUUniversidade Federal do Rio Grande · BRUniversity of Rio Grande and Rio Grande Community College · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAirway edema and mucus plugging are the predominant pathological features in infants with acute viral bronchiolitis. Nebulized hypertonic saline solution may reduce these pathological changes and decrease airway obstruction.

objectivesTo assess the effects of nebulized hypertonic saline solution in infants with acute viral bronchiolitis. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, issue 4), which contains the Cochrane Acute Respiratory Infections Group Specialized Register; OLDMEDLINE (1951 to 1965); MEDLINE (1966 to November 2007); EMBASE (1974 to November 2007); and LILACS (November 2007). SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs using nebulized hypertonic saline alone or in conjunction with bronchodilators as an active intervention in infants up to 24 months of age with acute bronchiolitis. DATA COLLECTION AND ANALYSIS: Two review authors (ZL, MRA) independently performed data extraction and study quality assessment. We pooled the data from individual trials using the Cochrane statistical package Review Manager (RevMan). MAIN

resultsWe included four trials involving 254 infants with acute viral bronchiolitis (189 inpatients and 65 outpatients) in this review. Patients treated with nebulized 3% saline had a significantly shorter mean length of hospital stay compared to those treated with nebulized 0.9% saline (mean difference (MD) -0.94 days, 95% CI -1.48 to -0.40, P = 0.0006). The 3% saline group also had a significantly lower post-inhalation clinical score than the 0.9% saline group in the first three days of treatment (day 1: MD -0.75, 95% CI -1.38 to -0.12, P = 0.02; day 2: MD -1.18, 95% CI -1.97 to -0.39, P = 0.003; day 3: MD -1.28, 95% CI -2.57 to 0.00, P = 0.05). The effect of nebulized hypertonic saline in improving clinical score was greater among outpatients than inpatients. No adverse events related to 3% saline inhalation were reported. AUTHORS'

conclusionsCurrent evidence suggests nebulized 3% saline may significantly reduce the length of hospital stay and improve the clinical severity score in infants with acute viral bronchiolitis.

Indexed as

Acute DiseaseBronchiolitis, ViralBronchodilator AgentsHumansInfantNebulizers and VaporizersRandomized Controlled Trials as TopicSaline Solution, HypertonicBronchodilator AgentsSaline Solution, Hypertonic

Identifiers

PMID18843717
OpenAlexW69516937

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.