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Pediatría Atención Primaria

versão impressa ISSN 1139-7632

Resumo

FERRER VAZQUEZ, Mario et al. Hospital treatment of moderate-severe bronchiolitis, hypertonic or physiological saline? Analysis of risk factors associated with readmission. Rev Pediatr Aten Primaria [online]. 2019, vol.21, n.82, pp.e31-e40.  Epub 14-Out-2019. ISSN 1139-7632.

Introduction

Although numerous studies have been published to date on the subject of inpatient management of bronchiolitis and the promising outcomes obtained with hypertonic saline, this subject remains controversial.

Materials and methods

We conducted a prospective observational study to assess the effectiveness of 3% hypertonic saline compared to physiological saline in the inpatient management of bronchiolitis, understood as the achieved reductions in length of stay and clinical severity scores. In a second phase, we analysed the risk factors associated with readmission due to bronchospasm in the same sample of patients.

Results

We included 67 out of the 73 patients admitted with bronchiolitis in the analysis, of who 9 received physiological saline and 58 hypertonic saline, with or without an added bronchodilator. The mean length of stay was 6.07 ± 3.12 days in the physiological saline group and 6.67 ± 4.36 days in the hypertonic saline group. The mean severity score (Wood-Downes scale modified by Ferrés) was 3.67 ± 1.1 in the physiological saline group versus 3.16 ± 1.1 in the hypertonic saline group. In the second phase of the study, we found a readmission rate of 8.2%.

Conclusion

We did not find statistically significant differences between the two groups in the length of stay or in the improvement in the clinical severity score or duration of oxygen therapy. Although the sample size was small, we did not find any trends in our sample suggesting the actual presence of significant differences. The factors associated most strongly with readmission were age of less than 6 months, male sex, having older siblings and exposure to smoke in the household.

Palavras-chave : Paediatrics; Bronchiolitis; Bronchospasm; Nebulizers; Hypertonic saline solution.

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