BET 1. NEBULISED HYPERTONIC SALINE SIGNIFICANTLY DECREASES LENGTH OF HOSPITAL STAY AND REDUCES SYMPTOMS IN CHILDREN WITH BRONCHIOLITIS

2009 ◽  
Vol 26 (7) ◽  
pp. 518-519
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Length Of Hospital Stay

scholarly journals Tolvaptan in the Management of Acute Euvolemic Hyponatremia After Transsphenoidal Surgery: A Retrospective Single-Center Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Rita Indirli ◽  
Júlia Ferreira de Carvalho ◽  
Arianna Cremaschi ◽  
Beatrice Mantovani ◽  
Elisa Sala ◽  
...  
Keyword(s):  
Side Effects ◽  
Hospital Stay ◽  
Hypertonic Saline ◽  
Transsphenoidal Surgery ◽  
Length Of Hospital Stay ◽  
Treatment Modalities ◽  
Fluid Restriction ◽  
Close Monitoring ◽  
Osmotic Demyelination ◽  
Sodium Correction

IntroductionSyndrome of inappropriate antidiuresis (SIAD) can be a complication of hypothalamus-pituitary surgery. The use of tolvaptan in this setting is not well established, hence the primary aim of this study was to assess the sodium correction rates attained with tolvaptan compared with standard treatments (fluid restriction and/or hypertonic saline). Furthermore, we compared the length of hospital stay in the two treatment groups and investigated the occurrence of overcorrection and side effects including osmotic demyelination syndrome.MethodsWe retrospectively reviewed 308 transsphenoidal surgical procedures performed between 2011 and 2019 at our hospital. We selected adult patients who developed post-operative SIAD and recorded sodium monitoring, treatment modalities and outcomes. Correction rates were adjusted based on pre-treatment sodium levels.ResultsTwenty-nine patients (9.4%) developed post-operative SIAD. Tolvaptan was administered to 14 patients (median dose 15 mg). Standard treatments were employed in 14 subjects (fluid restriction n=11, hypertonic saline n=1, fluid restriction and hypertonic saline n=2). Tolvaptan yielded higher adjusted sodium correction rates (12.0 mmolL-1/24h and 13.4 mmolL-1/48h) than standard treatments (1.8 mmolL-1/24h, p<0.001, and 4.5 mmolL-1/48h, p=0.004, vs. tolvaptan). The correction rate exceeded 10 mmolL-1/24h or 18 mmolL-1/48h in 9/14 and 2/14 patients treated with tolvaptan, respectively, and in no patient who received standard treatments. No side effects including osmotic demyelination occurred. Tolvaptan was associated with a shorter hospital stay (11vs.15 days, p=0.01).ConclusionsTolvaptan is more effective than fluid restriction (with or without hypertonic saline) and allows for a shortened hospital stay in patients with SIAD after transsphenoidal surgery. However, its dose and duration should be carefully tailored, and close monitoring is recommended to allow prompt detection of overcorrection.

scholarly journals Comparative Efficacy of Nebulized 3% Hypertonic Saline versus 0.9% Normal Saline in Children with Acute Bronchiolitis

2018 ◽  
Vol 42 (3) ◽  
pp. 130-137 ◽  
Author(s):  
Khandaker Tarequl Islam ◽  
Abid Hossan Mollah ◽  
Abdul Matin ◽  
Mahmuda Begum
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Severity Score ◽  
Oxygen Therapy ◽  
Length Of Hospital Stay ◽  
Clinical Severity ◽  
Acute Bronchiolitis ◽  
Group I ◽  
Group Ii

Background: Acute bronchiolitis is leading cause of hospitalization in infants below 2 years of age. Bronchiolitis being a viral disease, there is no effective treatment. 3% nebulized hypertonic saline and 0.9% nebulized normal saline are often used, although there is disagreement over their efficacy. The aim of this study was to evaluate the efficacy of 3% hypertonic saline in children with acute bronchiolitis in reducing clinical severity and length of hospital stay. Methodology: A randomized control trial carried out in the Department of Pediatrics, Dhaka Medical College Hospital from January 2013 to December 2013.Ninty children from 1 month to 2 years of age hospitalized with clinical bronchiolitis were randomized to receive 3% nebulized hypertonic saline(Group-I) or 0.9% nebulized normal saline (Group-II). Nebulization was done 8 hourly until discharge. Outcome variable were clinical severity score, duration of oxygen therapy and length of hospital stay. Results: Baseline clinical severity score and O2 saturation were in group-I 9.0±1.0 and 94.9±1.7 and in group- II 9.3±1.8 and 94.6±2.6 respectively (p>0.05). At 72 hours, the mean severity score for the group-I was 1.64±0.99 and that for the group-II was 3.0 ± 1.48 (95% CI -2.17 to - 0.53, p=0.002). The cases of group-I required a shorter duration of oxygen therapy compared to those of group-II (15.0±6.0 hours vs 26.4±5.37 hours, 95% CI -20.35 to -2.44, p<0.05). Forty two (93.3%) of the group-I children recovered by the end of72 hours and discharged whereas 26 (57.8%) of the group-II children recovered during the same period (p<0.05). Length of hospital stay was shorter in group-I compared to group-II (58.1±22.0 hours vs 74.7±27.2 hours, 95% CI -26.89 to- 6.17, p=0.002). None of the cases encountered any side-effects. Conclusion: Nebulization with 3% hypertonic saline significantly reduced clinical severity, length of hospital stay and duration of oxygen therapy in case of acute bronchiolitis in comparison to 0.9% normal saline and was safe. Bangladesh J Child Health 2018; VOL 42 (3) :130-137

scholarly journals The effect of 3% and 6% hypertonic saline in viral bronchiolitis: a randomised controlled trial

2014 ◽  
Vol 44 (4) ◽  
pp. 913-921 ◽  
Author(s):  
Jasmijn Teunissen ◽  
Anne H.J. Hochs ◽  
Anja Vaessen-Verberne ◽  
Annemie L.M. Boehmer ◽  
Carien C.J.M. Smeets ◽  
...  
Keyword(s):  
Sodium Chloride ◽  
Randomised Controlled Trial ◽  
Hospital Stay ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Controlled Trial ◽  
Tube Feeding ◽  
Length Of Hospital Stay ◽  
Supplemental Oxygen ◽  
Randomised Controlled

Bronchiolitis is a common disorder in young children that often results in hospitalisation. Except for a possible effect of nebulised hypertonic saline (sodium chloride), no evidence-based therapy is available. This study investigated the efficacy of nebulised 3% and 6% hypertonic saline compared with 0.9% hypertonic saline in children hospitalised with viral bronchiolitis.In this multicentre, double-blind, randomised, controlled trial, children hospitalised with acute viral bronchiolitis were randomised to receive either nebulised 3%, 6% hypertonic saline or 0.9% normal saline during their entire hospital stay. Salbutamol was added to counteract possible bronchial constriction. The primary endpoint was the length of hospital stay. Secondary outcomes were need for supplemental oxygen and tube feeding.From the 292 children included in the study (median age 3.4 months), 247 completed the study. The median length of hospital stay did not differ between the groups: 69 h (interquartile range 57), 70 h (IQR 69) and 53 h (IQR 52), for 3% (n=84) and 6% (n=83) hypertonic saline and 0.9% (n=80) normal saline, respectively, (p=0.29). The need for supplemental oxygen or tube feeding did not differ significantly. Adverse effects were similar in the three groups.Nebulisation with hypertonic saline (3% or 6% sodium chloride) although safe, did not reduce the length of stay in hospital, duration of supplemental oxygen or tube feeding in children hospitalised with moderate-to-severe viral bronchiolitis.

scholarly journals Exploring the Efficacy of Using Hypertonic Saline for Nebulizing Treatment in Children with Bronchiolitis: a Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Chia-Wen Hsieh ◽  
Hui-Chuan Su ◽  
Kee-Hsin Chen ◽  
Chiehfeng Chen
Keyword(s):  
Respiratory Distress ◽  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Hypertonic Saline ◽  
Saline Solution ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Controlled Trials ◽  
Acute Bronchiolitis ◽  
Randomized Controlled

Abstract Introduction: Acute bronchiolitis is the most common lower respiratory infection in children. It is particularly prone to dyspnea among children under two years old. Inhaled hypertonic saline (HS) has recently been shown to be a favorable therapy, because of its facility to draw fluid from the submucosa and adventitial spaces, decreasing airway edema. The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of HS in the implementation of vapor treatment 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: In total, 4186 children from 32 publications were included. Compared to the control group, the HS group exhibited significantly reducing the level of severity of respiratory distress, included studies used the Clinical Severity Score (95% CI −1.15, −0.27, I² = 73%) and Respiratory Distress Assessment Instrument (95% CI −0.95, −0.26, I²= 0%) for evaluation respectively. Further, the HS group decreased the length of hospital stay 0.54 days (95% CI −0.86, −0.32, I²= 81%). Conclusion: We conclude that nebulized 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 rigor randomize controlled trails with large sample size are needed.

scholarly journals Hypertonic saline versus normal saline nebulization in hospitalized children with acute bronchiolitis.

2020 ◽  
Vol 27 (12) ◽  
pp. 2734-2738
Author(s):  
Maleeha Saleem ◽  
Maria Saleem ◽  
Asim Khurshid
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Severity Score ◽  
Length Of Hospital Stay ◽  
Clinical Severity ◽  
Hospitalized Children ◽  
Acute Bronchiolitis ◽  
Group A ◽  
Group B

Objectives: To compare mean length of hospital stay (LOHS) after treatment with nebulized hypertonic saline (HS) versus normal saline (NS) in hospitalized children with acute bronchiolitis (AB). Study Design: Randomized Control Trial. Setting: Department of Pediatric Medicine, The Children’s Hospital and Institute of the Child Health, Multan. Period: July 2018 to January 2019. Material & Methods: A total of 206 hospitalized children having AB were enrolled. Group A (n=103) was nebulized with 2 ml of 3 % HS while group B (n=103) was nebulized with 2 ml of 0.9% saline solution. Clinical severity score was calculated daily to monitor progress of patients. Patients were discharged from hospital with clinical severity score of 4 or less and length of hospital stay was noted. Results: Overall, mean age was 5.83±4.48 months. Among 206 patients 139 (67.5%) were males and 67 (32.5%) females. Mean duration of disease was noted to be 3.57+2.2 days. In Group-A, mean LOHS was 36.29+18.4 hours in comparison to 39.15+16.1 hours in Group B (p-value = 0.2365). Conclusion: Nebulized HS 3% and NS 0.9% were not found to have any significant advantage over each other in terms of LOHS among hospitalized children having acute bronchiolitis.

scholarly journals A comparative study of inhalational therapy versus supportive management in children aged 2 months to 2 years suffering from acute bronchiolitis

2018 ◽  
Vol 5 (2) ◽  
pp. 383
Author(s):  
Shaik Nazeer Ahmed ◽  
Suman Poosala
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Length Of Hospital Stay ◽  
P Value ◽  
Acute Bronchiolitis ◽  
Cross Sectional ◽  
Discharge Data ◽  
Nebulized Salbutamol ◽  
Group B ◽  
Supportive Management

Background: The study was conducted with the aim to compare the effectiveness of nebulized hypertonic (3%) saline and nebulized salbutamol over supportive management to assess and monitor the clinical response in the above three modalities of management, to compare the length of stay in the hospital and to identify the risk factors for severe disease.Methods: This descriptive, cross-sectional hospital-based study was conducted at RICH Pediatric Hospital, Pogathota, Nellore, Andhra Pradesh from January 2015 to October 2016. A total of 120 children were included in the study. They were randomized into three treatment groups consisting of 40 in each. Group A received only supportive management, Group B received nebulization with 4 ml of 3% hypertonic saline along with supportive management and Group C received nebulization with 2.5 ml (2.5 mg) of salbutamol along with supportive management. Nebulization were given at intervals of 4 hours, six times a day until the patient was ready for discharge. Data was entered in Microsoft excel and analysis was done using SPSS version. A p-value of <0.05 was considered to be statistically significant.Results: Out of 120 children involved in the study, majority 56 (46.66%) children were <6 months age. Male preponderance was observed in the study (M:F-1.4:1). Higher proportion of moderate to severe cases was from rural area (61 cases). More severe cases were seen in lower socioeconomic class people and who had history of second hand smoking (21.67%). Clinically better improvement was seen in children that received nebulized hypertonic saline along with supportive management with mean length of hospital stay of 2.5 days when compared to only supportive management with mean length of hospital stay of 3.25 days. The mean length of hospital stays with nebulized salbutamol along with supportive management is 3.05 days which is not clinically significant. Of the 120 children studied, 118 (98.33%) survived and were discharged, while 2 children who presented critically succumbed to death (1.67%).Conclusions: Therapy with nebulized 3% hypertonic saline reduced the length of hospital stay in children <2 years suffering from acute bronchiolitis. Due to the efficacy and cost-effectiveness of the treatment, nebulized hypertonic saline should be considered for clinical management of acute bronchiolitis in children <2 years.

scholarly journals Comparative Efficacy of Nebulized 7% Hypertonic Saline versus 3% Hypertonic Saline in Children with Acute Bronchiolitis

2018 ◽  
Vol 26 (2) ◽  
pp. 153-156
Author(s):  
Md Saiful Islam ◽  
Md Abid Hossain Mollah ◽  
Tafazzal Hossain Khan ◽  
Chandan Kumar Shaha ◽  
Md Zahir Uddin ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Severity Score ◽  
Oxygen Therapy ◽  
Length Of Hospital Stay ◽  
Saline Group ◽  
Clinical Severity ◽  
Acute Bronchiolitis ◽  
Medical College ◽  
Group I

Background: Acute bronchiolitis is an acute viral lower respiratory tract infection in early childhood and is the leading cause of hospitalization in infants below 2 years of age. Being a viral disease, there is no effective treatment of this problem other than supportive care. To provide this care, both 3% hypertonic saline and 7% hypertonic saline has been used and found effective. However, which option is more effective to reduce clinical severity and length of hospital stay, still remain unsettled.Objective: To determined the efficacy of 7% hypertonic saline in children with acute bronchiolitis.Methodology: The study was a randomized controlled trial and carried out in the Department of Paediatrics, Dhaka Medical College Hospital (DMCH), Dhaka between January 2015 to December 2016. A total of 135 children from 1 month to 2 years of age irrespective of sex with clinical presentation of acute bronchiolitis admitted in the paediatrics ward of DMCH were included in the study and were randomly assigned to either 7% nebulized hypertonic saline (Group-I = 45) or to 3% nebulized hypertonic saline (Group-II = 90) in ratio (1:2). The main outcome variables were clinical severity score and length of hospital stay. The outcome was evaluated at 12 hourly and 24 hourly intervals till discharge (up to 120 hours)Result: In this study both groups were almost similar with respect to their demographic characteristics like age and sex and baseline clinical characteristics. The study demonstrated that respiratory rate score, wheezing score, retraction score, general condition score and clinical severity score of both treatment modalities were reduced. Children of group-I(7% HS) 40(88.9%) recovered at the end of 72 hours where as 67(74.4%) of the children of group-II(3% HS) recovered from the disease during the same period. Length of hospital stay was shorter in 7% hypertonic saline group compared to 3% hypertonic saline group (56.36±16.33 hours vs63.07±21.48 hours, p=.067). The patients of 7% hypertonic saline group required a shorter duration of oxygen therapy compared to 3% hypertonic saline group (16.53±3.98) hours vs (20.25± 4.15) hours, (p=0.109) respectively.Conclusion: Nebulized 7% hypertonic saline as well as 3% hypertonic saline both were effective in acute bronchiolitis and found no significant difference in efficacy between these options in terms of reducing clinical severity, length of hospital stay and duration of oxygen therapy. No side effect were observed in either group.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 153-156

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

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chia-Wen Hsieh ◽  
Chiehfeng Chen ◽  
Hui-Chuan Su ◽  
Kee-Hsin Chen
Keyword(s):  
Respiratory Distress ◽  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Hypertonic Saline ◽  
Saline Solution ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Controlled Trials ◽  
Acute Bronchiolitis ◽  
Randomized Controlled

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.

scholarly journals COMPARATIVE STUDY TO ASSESS THE EFFECTIVENESS OF NEBULIZED 3% HYPERTONIC SALINE AND NEBULIZED LEVOSALBUTAMOL IN THE MANAGEMENT OF BRONCHIOLITIS

2020 ◽  
pp. 93-95
Author(s):  
SARA SHIREEN ◽  
SAFURA SULTANA ◽  
KHADIJA AKHTAR OMER ◽  
ATIKA BEGUM QUTUB ◽  
NARAYAN REDDY U
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Length Of Hospital Stay ◽  
Assessment Instrument ◽  
Clinical Severity ◽  
Hospital Charges ◽  
Economic Burden Of Disease ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: The objective of the study was to compare the effects of nebulized 3% hypertonic saline and nebulized levosalbutamol in the management of bronchiolitis. Methods: Seventy children of age 1–24 months admitted into the hospital with the diagnosis of bronchiolitis. Participants were divided into two groups of 35 each. Group A was given nebulized 3% hypertonic saline and Group B was given nebulized levosalbutamol. Modified respiratory distress assessment instrument (RDAI) is used at admission, at 48 h after admission, and at the time of discharge to identify the reduction in scores between two groups. Results: The mean age of patients in the study population was 10.1±6.4 months. The mean birth weight of patients in Group A and Group B was 3.00±0.61 and 3.12±0.75. The percentage of male patients was 57.1% and the percentage of female patients was 42.8%. The modified RDAI score in Group A and Group B at admission, 48 h of admission, and at the time of discharge was 4.34±0.87, 2.4±1.03, and 0.67±0.05 (p=0.04) and 4.11±0.58, 3.60±1.00, and 2.51±0.96 (p=0.12). The hospital stay was observed to be lowered in Group A (3.77±0.88) compared to Group B (5.43±0.92; p=0.04). Conclusion: From the findings of our study, we conclude that nebulized 3% hypertonic saline, as it acts by hindering the pathophysiologic mechanism of bronchiolitis, is more effective in reducing the clinical severity score and length of hospital stay. Further 3% hypertonic saline also have the additional benefit of decreasing the economic burden of disease as it is safe, inexpensive, reduces the inpatient hospital charges by reducing the length of stay.

scholarly journals Study of therapeutic effects of nebulized adrenaline alone, nebulized adrenaline plus injectable dexamethasone (in combination) and nebulized 3% hypertonic saline alone in clinically diagnosed cases of bronchiolitis

2017 ◽  
Vol 4 (4) ◽  
pp. 1414
Author(s):  
Ishwari Prasad Verma ◽  
Pukhraj Garg ◽  
B. S. Karnawat ◽  
Anil Jain ◽  
Pradeep Verma ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Hypertonic Saline ◽  
Severe Disease ◽  
Length Of Hospital Stay ◽  
Clinical Severity ◽  
Therapeutic Effects ◽  
Lung Field ◽  
Older Children ◽  
Recurrent Wheezing ◽  
Syncytial Virus

Background: Bronchiolitis is a common respiratory tract infection in young children. Respiratory Syncytial Virus (RSV) is the common etiological agent, with highest incidence occurring between December and March. 90% of children are infected in the first 2 years of life. Infants hospitalized are more likely to have respiratory problems as older children, especially recurrent wheezing. The treatment is mainly supportive. Mild cases are managed with antipyretics, hydration and home remedies/cough formulas. Moderate cases may require humidified oxygen, parenteral fluids to maintain hydration and nebulization with bronchodilators. Nebulization with adrenaline along with IV dexamethasone more effective in terms of reduction in the duration of the symptoms and length of hospital stay.Methods: This prospective study was done for 1 year from May 2015 onwards.120 clinically diagnosed cases of bronchiolitis were included. cases were classified into 2 groups on the basis of RDAI score, Mild cases with score of 4-15 &Severe cases with score of >15. All cases were divided in 3 therapeutic groups, A- nebulized with adrenaline alone, B- single dose of IV dexamethasone and nebulized adrenaline, C- nebulized with 3% hypertonic saline alone. Nebulization was done at 0,30,60 minutes interval and then 4 hourly till improvement of symptoms.Results: Out of total 120 cases,74(61.66%) belonged to age group of 2-6 months. Males were more affected than females with ratio of 2.15:1. Most of patients (83.3%) had hyperinflated lung field in X-ray finding. Children with preterm birth had severe disease. The mean RDAI score was found to be reduced highest in adrenaline plus dexamethasone group that is 2.37±0.80 within 24 hours of admission with 26.24% reduction in the length of hospital stay as compared to group A and 20.61% as compared to group C.Conclusions: combination of nebulized adrenaline and dexamethasone is better in terms of reducing clinical severity, length of hospital stay in children with moderate severity of acute bronchiolitis in comparison to adrenaline alone and 3% hypertonic saline alone. 

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