Farmacoriflessioni
Soluzione salina ipertonica in corso di bronchiolite acuta: fare meno è fare di più?
Treatment with nebulized hypertonic solution in children with acute bronchiolitis: “less is more”
Sara Pusceddu1, Giorgio Cozzi2
1UOC di Pediatria e Neonatologia, Ospedale di Ravenna, AUSL della Romagna
2IRCCS Materno-Infantile “Burlo Garofolo”, Trieste
Novembre 2015 - pagg. 581 -584
Abstract
Since 2013, all the published trials, without any exception, showed that treatment with
nebulized hypertonic solution did not reduce the length of stay in hospital (LOS) of children
with acute bronchiolitis. Trials published before 2013 were flawed by significant
methodological weakness e.g. no uniform bronchiolitis definition, heterogeneity of interventions
or clinical scoring and, above all, the inclusion of children older than 12 months.
Nevertheless, considering all trials, the supposed reduction in the LOS is nearly of 11
hours only. Since 2013, only one trial, at high risk of patients’ selection bias, showed a
benefit of this treatment to reduce the risk of hospitalization of these children. The most recent
and better methodologically designed trials do not support the use of nebulized hypertonic
solution in children with acute bronchiolitis. Therefore, available evidence does
not allow to consider hypertonic solution potentially effective and well tolerated for acute
bronchiolitis neither does justify its routinely use in clinical practice.
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Corrispondenza: sarapusc@hotmail.it