Cruz Márcia, Roteia Catarina, Marques Ferreira Adriana, Barros Roberta, Sevivas Hugo, Gomes Tânia, Bandeira Andreia Silva
Family Medicine, USF Physis, Unidade Local de Saúde de Alto Ave, Guimarães, PRT.
Family Medicine, USF Saúde Oeste, Unidade Local de Saúde de Braga, Braga, PRT.
Cureus. 2024 Dec 10;16(12):e75464. doi: 10.7759/cureus.75464. eCollection 2024 Dec.
Acute upper respiratory tract infections (URTIs) are defined as infectious diseases confined anatomically to the upper respiratory tract, with a duration of up to 28 days. Treatment for URTIs in pediatrics typically involves antipyretics and decongestants and, at times, antibiotics, despite most infections being viral. Nasal irrigation with saline solution is frequently used as an adjunct treatment for URTI symptoms. Currently, there is no consensus on whether nasal irrigation with saline offers significant benefits in reducing the severity of URTI symptoms. This systematic review aims to assess the scientific evidence supporting nasal irrigation with saline as a recommendation to alleviate symptom severity in pediatric URTI cases. We conducted a systematic literature search in PubMed, Cochrane Library, Medline, and Scopus databases, covering the period from January 2010 to May 2024 in Portuguese, Spanish, and English. MeSH terms used were: (((pediatrics) OR (children) OR (infant) OR (adolescent) OR (child)) AND ((isotonic saline solution) OR (nasal douching) OR (nasal saline irrigation) OR (nasal lavage fluid)) AND ((respiratory disease) OR (upper respiratory tract infection))). Only randomized controlled trials were included, and we assessed the risk of bias using the Cochrane risk-of-bias tool (ROBIS 2.0). The Strength of Recommendation Taxonomy (SORT) was applied to determine the level of evidence and strength of recommendation. The initial search yielded 158 articles, of which only four met the criteria for inclusion in this systematic review. All studies evaluated whether saline nasal irrigation, with or without additional treatments, contributes to symptom improvement in pediatric URTIs. Notably, some studies reported symptom relief and even faster recovery times with its use. Based on our analysis, nasal irrigation with saline solution may reduce symptom severity in children with URTIs, with a level of evidence of 2 and a recommendation strength of B. Further research with more robust methodologies is needed to confirm these findings.
急性上呼吸道感染（URTIs）被定义为解剖学上局限于上呼吸道的传染病，病程长达28天。儿科URTIs的治疗通常包括退烧药和解充血剂，有时还包括抗生素，尽管大多数感染是由病毒引起的。用盐溶液进行鼻腔冲洗经常被用作URTI症状的辅助治疗。目前，对于用盐水进行鼻腔冲洗是否能显著减轻URTI症状，尚无共识。本系统评价旨在评估支持用盐水进行鼻腔冲洗以减轻儿科URTI病例症状严重程度的科学证据。我们在PubMed、Cochrane图书馆、Medline和Scopus数据库中进行了系统的文献检索，涵盖2010年1月至2024年5月期间的葡萄牙语、西班牙语和英语文献。使用的医学主题词为：（（（儿科）或（儿童）或（婴儿）或（青少年）或（小孩））且（（等渗盐溶液）或（鼻腔灌洗）或（鼻腔盐水冲洗）或（鼻腔灌洗液））且（（呼吸道疾病）或（上呼吸道感染）））。仅纳入随机对照试验，我们使用Cochrane偏倚风险工具（ROBIS 2.0）评估偏倚风险。应用推荐分级系统（SORT）来确定证据水平和推荐强度。初步检索得到158篇文章，其中只有4篇符合纳入本系统评价的标准。所有研究都评估了盐水鼻腔冲洗（无论是否有其他治疗）是否有助于改善儿科URTIs的症状。值得注意的是，一些研究报告称使用盐水鼻腔冲洗可缓解症状，甚至缩短恢复时间。基于我们的分析，用盐溶液进行鼻腔冲洗可能会降低URTIs患儿的症状严重程度，证据水平为2级，推荐强度为B级。需要采用更可靠方法进行进一步研究以证实这些发现。
