Cochrane review: Nebulized hypertonic saline solution for acute bronchiolitis in infants
Bibliographic record
Abstract
Abstract Background Airway edema and mucus plugging are the predominant pathological features in infants with acute viral bronchiolitis. Nebulized hypertonic saline solution may reduce these pathological changes and decrease airway obstruction. Objectives To assess the effects of nebulized hypertonic saline solution in infants with acute viral bronchiolitis. Search strategy We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library2007, issue 4), which contains the Cochrane Acute Respiratory Infections Group Specialized Register; OLDMEDLINE (1951 to 1965); MEDLINE (1966 to November 2007); EMBASE (1974 to November 2007); and LILACS (November 2007). Selection criteria Randomised controlled trials (RCTs) and quasi‐RCTs using nebulized hypertonic saline alone or in conjunction with bronchodilators as an active intervention in infants up to 24 months of age with acute bronchiolitis. Data collection and analysis Two review authors (ZL, MRA) independently performed data extraction and study quality assessment. We pooled the data from individual trials using the Cochrane statistical package Review Manager (RevMan). Main results We included four trials involving 254 infants with acute viral bronchiolitis (189 inpatients and 65 outpatients) in this review. Patients treated with nebulized 3% saline had a significantly shorter mean length of hospital stay compared to those treated with nebulized 0.9% saline (mean difference (MD) ‐0.94 days, 95% CI ‐1.48 to ‐0.40, P = 0.0006). The 3% saline group also had a significantly lower post‐inhalation clinical score than the 0.9% saline group in the first three days of treatment (day 1: MD ‐0.75, 95% CI ‐1.38 to ‐0.12, P = 0.02; day 2: MD ‐1.18, 95% CI ‐1.97 to ‐0.39, P = 0.003; day 3: MD ‐1.28, 95% CI ‐2.57 to 0.00, P = 0.05). The effect of nebulized hypertonic saline in improving clinical score was greater among outpatients than inpatients. No adverse events related to 3% saline inhalation were reported. Authors' conclusions Current evidence suggests nebulized 3% saline may significantly reduce the length of hospital stay and improve the clinical severity score in infants with acute viral bronchiolitis. Plain Language Summary Nebulized hypertonic saline solution for acute bronchiolitis in infants Acute viral bronchiolitis is the most common lower respiratory tract infection in infants, but the standard treatment remains supportive care. This review was conducted to assess the effects of nebulized hypertonic saline, which can increase clearance of mucus, in these patients. Four randomized trials involving 254 infants were included. Analysis of the pooled data suggests that nebulized 3% saline may significantly reduce the length of hospital stay and improve the clinical severity score in infants with acute viral bronchiolitis.There were no adverse effects noted with nebulized hypertonic saline when administered along with bronchodilators.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.017 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.005 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".