Name: Kristyn Joy D.

Atangen Date: October 30, 2020

Group: BSN IV A-D Name of CI: Gaiserica Lea Salic-o

I. TITLE: Exploring The Efficacy Of Using Hypertonic Saline For Nebulizing Treatment In
Children With Bronchiolitis: A Meta-analysis Of Randomized Controlled Trials
AUTHOR: Chia-Wen Hsieh, Chiehfeng Chen, Hui-Chuan Su, and Kee-Hsin Chen
SOURCE: BMC Pediatr 20, 434 (2020). https://doi.org/10.1186/s12887-020-02314-3

YEAR OF PUBLICATION: September 14, 2020

II. SUMMARY

Bronchiolitis is the most common lower respiratory tract infection in infants, with
respiratory syncytial virus being the leading cause. Airway edema and mucus plugging are
believed to be the pathologic processes causing morbidity in cases of viral bronchiolitis.
Supportive treatment is the standard of care. In addition, nebulized hypertonic saline may be
beneficial in relieving symptoms.

A systematic review included double-blind, randomized, controlled clinical trials evaluating the
effect of nebulized hypertonic (3% or higher) saline solution alone or in conjunction with
bronchodilators in children with acute bronchiolitis compared with nebulized normal (0.9%)
saline. Nebulized hypertonic saline resulted in a statistically significant reduction in length of
hospital stay. Nebulized hypertonic saline also reduced the risk of hospitalization by 20%
compared with 0.9% saline. No significant adverse events related to hypertonic saline inhalation
were reported.

No significant adverse events related to hypertonic saline inhalation were observed in the trials
reported in systematic reviews. No patients withdrew because of adverse events or clinical
deterioration. The only consistent finding among all trials is the absence of any serious adverse
event associated with the use of hypertonic saline. Considering the prevalence of bronchiolitis
and the financial and emotional cost of hospitalization, possible reduction in admission rate and
hospital stay with minimal adverse events provides enough evidence to recommend this
treatment for acute bronchiolitis.

III. PERSONAL INSIGHTS

In this study there are many trials that were done just to justify the result of this study. We all
know that Bronchiolitis is the most common lower-respiratory infection in Children especially
those 2 years old and below. When it comes to this study they are pertaining to the reduction of
stay of patients in the hospital, aside from financial and emotional problem they also considered
comfort of the child since when it comes to Bronchiolitis children are in distress and as a nurse
all we want to provide is a support and comfort but we can’t do that without this studies. In my
opinion Hypertonic saline is not a bad idea to use since in other related studies of this article is
they are using 0.9% saline since then, its a big help for pediatric patient because they are
vulnerable, they can’t even explained properly what they feel and in this study they pinpoint the
comfort of a child especially during sleeping time its the least thing we can do to comfort them to
give them nebulizer to relieve the distress their facing off. Since there are no contraindication in
using hypertonic even in the earlier studies then it might be a better improved and to be
implemented alternative way rather than buying expensive drugs, as well as, to alleviate burden
to financial problem of parents because Bronchiolitis is expensive since its not only the drug for
nebulizer that you need to buy but there are antibiotics and other drugs for bronchiolitis that are
more expensive to be consider.

IV. NURSING IMPLICATIONS

A. To Nursing Education
 Implication of this study to Nursing Education is that since we are used to drugs,
all we know is to use drug since it is what we know the most effective way to
relieve pain or other problems. This trial is important in education it gave us more
ideas to why not use other resources rather than using high doses of drugs. Aside
from knowing that Bronchiolitis is common in Children then we must also consider
the patient, the lenght of stay in the hospital and the efficacy of the study. As a
nursing student this is a big help for us to know about alternative use of other
resources that are tested aside from giving support and comfort to a vulnerable
patient

B. To Nursing Profession
 This Article can be use as a guide for those who are in the medical fields. Many
trials of this study of nebulized hypertonic saline are all the same they didn’t find
any contraindications that can be a barrier for this study. Its a big help for those in
medical field to know about this because this study is not just implying to the use of
hypertonic but also talking about the support and comfort that we might provide.

C. To Nursing Research
 Implication of this Article to Nursing research is that since in Nursing we need
evidenced based during research not only research but all the things that we do we need
evidences, like articles and journals. This kind of article about the use of hypertonic
saline in nebulizing will improve the severity of respiratory distress, shorten the length
of stay in the hospital, and increase the children’s night-time sleep quality. It is
recommended that a large-scale randomized clinical trial with a standardized design be
conducted in the future to investigate the effects of hypertonic saline in children with
bronchiolitis.
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