University of Texas Health Science Center at San Antonio, Department of Pediatrics, and Christus Santa Rosa Children's Hospital, 7703 Floyd Curl Dr, MSC 7829, San Antonio, TX 78229, USA.
Pediatrics. 2010 Sep;126(3):e520-5. doi: 10.1542/peds.2009-3105. Epub 2010 Aug 16.
The goal was to determine an adverse event rate for nebulized hypertonic saline solution administered without adjunctive bronchodilators for infants with bronchiolitis.
This was a retrospective cohort study of the use of nebulized 3% saline for children<2 years of age who were hospitalized with the primary diagnosis of bronchiolitis at a single academic medical center. The medical records of study participants were analyzed for the use of nebulized 3% saline solution and any documented adverse events related to this therapy. Other clinical outcomes evaluated included respiratory distress scores, timing of the use of bronchodilators in relation to 3% saline solution, transfer to a higher level of care, and readmission within 72 hours after discharge.
A total of 444 total doses of 3% saline solution were administered, with 377 doses (85%) being administered without adjunctive bronchodilators. Four adverse events occurred with these 377 doses, for a 1.0% adverse event rate (95% confidence interval: 0.3%-2.8%). Adverse events were generally mild. One episode of bronchospasm was documented, for a rate of 0.3% (95% confidence interval: <0.01%-1.6%).
The use of 3% saline solution without adjunctive bronchodilators for inpatients with bronchiolitis had a low rate of adverse events in our center. Additional clinical trials of 3% saline solution in bronchiolitis should evaluate its effectiveness in the absence of adjunctive bronchodilators.
确定在没有附加支气管扩张剂的情况下雾化高渗盐水溶液用于毛细支气管炎婴儿的不良事件发生率。
这是一项回顾性队列研究，研究对象为在单一学术医疗中心因毛细支气管炎住院的<2 岁儿童，使用雾化 3%盐水。分析研究参与者的病历，了解是否使用了雾化 3%盐水溶液，以及与该治疗相关的任何记录不良事件。评估的其他临床结果包括呼吸困难评分、支气管扩张剂与 3%盐水溶液的使用时间关系、转至更高级别护理以及出院后 72 小时内再次入院。
共给予 444 总剂量的 3%盐水溶液，其中 377 剂量（85%）未附加支气管扩张剂。在这 377 剂量中发生了 4 起不良事件，不良事件发生率为 1.0%（95%置信区间：0.3%-2.8%）。不良事件通常较轻。记录到 1 例支气管痉挛，发生率为 0.3%（95%置信区间：<0.01%-1.6%）。
在我们中心，使用 3%盐水溶液而不附加支气管扩张剂治疗毛细支气管炎住院患者的不良事件发生率较低。毛细支气管炎中 3%盐水溶液的额外临床试验应评估其在没有附加支气管扩张剂的情况下的有效性。
