Hypertonic Saline for Brain Relaxation and Intracranial Pressure in Patients Undergoing Neurosurgical Procedures: A Meta-Analysis of Randomized Controlled Trials

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.

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Hypertonic saline in severe traumatic brain injury: a systematic review and meta-analysis of randomized controlled trials

CJEM ◽

10.1017/cem.2016.12 ◽

2016 ◽

Vol 18 (2) ◽

pp. 112-120 ◽

Cited By ~ 26

Author(s):

Elyse Berger-Pelleiter ◽

Marcel Émond ◽

François Lauzier ◽

Jean-François Shields ◽

Alexis F. Turgeon

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Intracranial Pressure ◽

Randomized Controlled Trials ◽

Hypertonic Saline ◽

Severe Traumatic Brain Injury ◽

Controlled Trials ◽

Cochrane Central Register ◽

Randomized Controlled

AbstractObjectivesHypertonic saline solutions are increasingly used to treat increased intracranial pressure following severe traumatic brain injury. However, whether hypertonic saline provides superior management of intracranial pressure and improves outcome is unclear. We thus conducted a systematic review to evaluate the effect of hypertonic saline in patients with severe traumatic brain injury.MethodsTwo researchers independently selected randomized controlled trials studying hypertonic saline in severe traumatic brain injury and collected data using a standardized abstraction form. No language restriction was applied. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and BIOSIS databases. We searched grey literature via OpenGrey and National Technical Information Service databases. We searched the references of included studies and relevant reviews for additional studies.ResultsEleven studies (1,820 patients) were included. Hypertonic saline did not decrease mortality (risk ratio 0.96, 95% confidence interval [CI] 0.83 to 1.11, I2=0%) or improve intracranial pressure control (weighted mean difference −1.25 mm Hg, 95% CI −4.18 to 1.68, I2=78%) as compared to any other solutions. Only one study reported monitoring for adverse events with hypertonic saline, finding no significant differences between comparison groups.ConclusionsWe observed no mortality benefit or effect on the control of intracranial pressure with the use of hypertonic saline when compared to other solutions. Based on the current level of evidence pertaining to mortality or control of intracranial pressure, hypertonic saline could thus not be recommended as a first-line agent for managing patients with severe traumatic brain injury.

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

BMC Pediatrics ◽

10.1186/s12887-020-02314-3 ◽

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.

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