PT  - JOURNAL ARTICLE
AU  - Dorit Ater
AU  - Hanita Shai
AU  - Bat-El Bar
AU  - Nir Fireman
AU  - Daiana Tasher
AU  - Ilan Dalal
AU  - Ami Ballin
AU  - Avigdor Mandelberg
TI  - Hypertonic saline and acute wheezing in pre-school children
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - 3282
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/3282.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/3282.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Background: Most acute wheezing episodes in preschool children are associated with viral respiratory tract infections, most commonly rhinovirus. Rhinovirus, like RSV, decreases extra-cellular ATP, leading to airway surface liquid dehydration. This, along with sub-mucosal edema, mucus plaques and inflammation cause failure of mucus clearance (MC). Such preschool children do not respond well to available treatments, including oral steroids. This calls for pro-MC and pro-hydration treatment like hypertonic saline. Methods: Randomized, controlled, double-blind study. Forty one children (mean age 31.9±17.4 months, range 1-6 years) presented with wheezing to the emergency department (ED) were randomized after one albuterol inhalation to receive either 4 ml of Hypertonic Saline 5% (HS), (n=16) or 4 ml of Normal saline (NS), (n=25) both with 0.5 ml albuterol, twice every 20 minutes in the ED and four times a day thereafter if hospitalized. Primary outcome measured was length of stay (LOS) and secondary outcomes were admission rate (AR) and clinical severity score (CS).Results: LOS was significantly shorter in the HS than in the NS group: median (range) 2 (0-6) days, versus 3 (0-5) days (P=0.027). AR was significantly lower in the HS than the NS group: 62.2% versus 92%. CS improved significantly in both groups but did not reach significance between them.View this table:Hospitalization rateConclusions: Using HS inhalations significantly shortens LOS and lowers AR in preschool children presenting with acute wheezing episode to the ED.