Background
Methods
Database searches
Inclusion criteria
Literature quality assessment
Data analysis
Sensitivity analysis
Results
Literature search results
Characteristics of included studies
Study | Patients | Intervention | Comparison | Outcome | |||
---|---|---|---|---|---|---|---|
year | Average age (male %) | 3% H/S | Additional drugs | 0.9% N/S | Additional drugs | ||
Country | RSV positive rate | ||||||
Al-Ansari et al. 2010 [30] [?]Saudi Arabia | < 18 mon Inpatients n = 114 | 3.9 mon (59.1%) No information | 5 mL (n = 58) | + 1.5 mg epinephrine | 5 mL (n = 56) | + 1.5 mg epinephrine | LOS CSS |
Angoulvant et al. 2017 [31] France | 6 wk. ~ 12 mon ED n = 772 | 3 mon (60.2%) 86.4% | 4 mL (n = 385) | 4 mL (n = 387) | RDAI ROH Adverse events | ||
Anil et al. 2010 [32] Turkey | 6 wk. ~ 24 mon ED n = 149 | 9.5 mon (64.5%) No information | 1) 4 mL (n = 39) 2) 4 mL (n = 36) | + 1.5 mg epinephrine + 2.5 mg salbutamol | 1) 4 mL (n = 38) 2) 4 mL (n = 36) | + 1.5 mg epinephrine + 2.5 mg salbutamol | ROH ROR |
Everard et al. 2014 [8] UK | < 12 mon Inpatients n = 291 | 3.4 mon (54.5%) 61.5% | 4 mL (n = 142) | + standard care | (n = 149) *Nebulizer use not reported | + standard care | LOS RDAI |
Flores et al. 2016 [27] Portugal | < 12 mon Inpatients n = 68 | 3.6 mon (52.9%) 85.4% | 3 mL (n = 33) | + 1.25 mg salbutamol | 3 mL (n = 35) | + 1.25 mg salbutamol | LOS CSS |
Florin et al. 2014 [28] USA | 2 ~ 24 mon ED n = 62 | 6.7 mon (45.2%) No information | 4 mL (n = 31) | 4 mL (n = 31) | ROH | ||
Grewal et al. 2009 [33] Canada | 6 wk. ~ 12 mon ED n = 46 | 5 mon (60.9%) 82.2% | 2.5 mL (n = 23) | + 0.5 mL 2.25% epinephrine | 2.5 mL (n = 23) | + 0.5 mL 2.25% epinephrine | RDAI ROH ROR |
Hou et al. 2016 [34] China | 1 ~ 11 mon Inpatients n = 34 | 6 M (50.4%) No information | (n = 17) *how many milliliters not reported | + 1.25 ml atrovent + 1 ml budesonide | (n = 17) *how many milliliters not reported | + 1.25 ml atrovent + 1 ml budesonide | LOS TOS FOWITN |
Ipek et al.2011 [35] Turkey | < 24 mon ED n = 120 | 7.9 mon (59.2%) No information | 1) 4 mL (n = 30) 2) 4 mL (n = 30) | + 0.15 mg/kg salbutamol | 1) 4 mL (n = 30) 2) 4 mL (n = 30) | + 0.15 mg/kg salbutamol | ROH |
Islam et al. 2018 [36] Bangladesh | 1 ~ 24 mon Inpatients n = 90 | 5.4 mon (56.6%) No information | 4 mL (n = 45) | 4 mL (n = 45) | LOS CSS | ||
Kanjanapradap et al. 2018 [37] Thailand | 6 mon~ 5 years Inpatients n = 47 | 20.1 mon (60%) 25.5% | 3.5 mL (n = 22) | + 2.5 mg salbutamol | 3.5 mL (n = 25) | + 2.5 mg salbutamol | |
Khanal et al. 2015 [38] Nepal | 6 wk. ~ 24 mon ED/OPD n = 100 | 9.7 M (48%) No information | 4 mL (n = 50) | + 1.5 mg epinephrine | 4 mL (n = 50) | + 1.5 mg epinephrine | ROR |
Kose et al. 2016 [39] Turkey | 1 ~ 24 mon Inpatients n = 70 | 7.6 mon (40.3%) No information | 2.5 mL (n = 35) | + 0.15 mg/kg salbutamol | 2.5 mL (n = 35) | + 0.15 mg/kg salbutamol | LOS CSS |
Kuzik et al. 2007 [40] Canada | < 18 mon Inpatients n = 91 | 4.7 mon (59.4%) 68.5% | 4 mL (n = 45) | 4 mL (n = 46) | LOS | ||
Kuzik et al. 2010 [41] Canada | < 24 mon ED n = 88 | 8.9 mon (77.5%) 47% History of asthma | 4 mL (n = 44) | + 1 mg salbutamol | 4 mL (n = 44) | + 1 mg salbutamol | RDAI ROH |
Li et al. 2014 [42] China | 2 ~ 18 mon OPD n = 84 | 7.2 mon (73.3%) No information | 2 mL (n = 42) | 2 mL (n = 42) | CSS | ||
Luo et al. 2010 [44] China | < 24 mon Inpatients n = 93 | 5.8 mon (60.2%) 69.9% | 4 mL (n = 50) | + 2.5 mg salbutamol | 4 mL (n = 43) | + 2.5 mg salbutamol | LOS CSS |
Luo et al. 2011 [43] China | < 24 mon Inpatients n = 112 | 5.9 mon (56.3%) 73.2% | 4 mL (n = 57) | 4 mL (n = 55) | LOS CSS | ||
Mahesh Kumar et al. 2013 [45] India | < 24 mon Inpatients n = 40 | 5.9 mon (62.5%) No information | 3 mL (n = 20) | + 0.15 mg/kg albuterol | 3 mL (n = 20) | + 0.15 mg/kg albuterol | LOS |
Mandelberg et al. 2003 [46] Israel | < 12 mon Inpatients n = 52 | 2.9 mon (57.7%) 86.5% | 4 mL (n = 27) | + 1.5 mg epinephrine | 4 mL (n = 25) | + 1.5 mg epinephrine | LOS CSS |
Miraglia et al. 2012 [47] Italy | < 24 mon Inpatients n = 106 | 4.5 mon (65.1%) 82% | 4 mL (n = 52) | + 1.5 mg epinephrine | 4 mL (n = 54) | + 1.5 mg epinephrine | LOS CSS |
Morikawa et al. 2018 [48] Japan | < 12 mon Inpatients n = 128 | 4.3 mon (39.2%) No information | 2 mL (n = 63) | + 0.5% 0.1 mL salbutamol | 2 mL (n = 65) | + 0.5% 0.1 mL salbutamol | LOS |
Ojha et al. 2014 [49] Nepal | 6 wk. ~ 24 mon Inpatients n = 59 | 8.5 mon (74%) No information | 4 mL (n = 28) | 4 mL (n = 31) | LOS | ||
Pandit et al. 2013 [50] India | 2 ~ 12 mon Inpatients n = 100 | Not reported (Not reported) No information | 4 mL (n = 51) | + 1 mL adrenaline | 4 mL (n = 49) | + 1 mL adrenaline | LOS |
Ratajczyk-Pekrul et al. 2016 [51] Poland | < 18 mon Inpatients n = 78 | 4.9 mon (58.9%) 53.5% | 3 mL (n = 41) | + 0.15 mg/kg salbutamol | 3 mL (n = 37) | + 0.15 mg/kg salbutamol | LOS |
Sarrell et al. 2002 [52] Israel | < 24 mon OPD n = 65 | 12.5 mon (59%) 80% | 2 mL (n = 33) | + 5 mg terbutaline | 2 mL (n = 32) | + 5 mg terbutaline | ROH |
Sharma et al. 2013 [53] India | 1 ~ 24 mon Inpatients n = 248 | 8.5 mon (76.2%) No information | 4 mL (n = 125) | + 2.5 mg salbutamol | 4 mL (n = 123) | + 2.5 mg salbutamol | LOS |
Silver et al. 2015 [54] USA | < 12 mon Inpatients n = 190 | 4.2 mon (61%) 67.5% History of asthma | 4 mL (n = 93) | 4 mL (n = 97) | ROR | ||
Tal et al. 2006 [55] Israel | < 24 mon Inpatients n = 41 | 2.6 mon (56.1%) 80.5% | 4 mL (n = 21) | + 1.5 mg epinephrine | 4 mL (n = 20) | + 1.5 mg epinephrine | LOS CSS |
Teunissen et al. 2014 [56] The Netherlands | < 24 mon Inpatients n = 164 | 3.4 mon (57.1%) 86.2% | 4 mL (n = 84) | + 2.5 mg salbutamol | 4 mL (n = 80) | + 2.5 mg salbutamol | LOS |
Wang et al. 2014 [57] China | 2 ~ 14 mon Inpatients n = 76 | 5.8 mon (56.6%) No information | 2 mL (n = 37) | + 0.5 ml salbutamol + 0.5 mg budesonide | 2 mL (n = 39) | + 0.5 ml salbutamol + 0.5 mg budesonide | LOS TOS FOWITN |
Wu et al. 2014 [58] USA | < 24 mon ED n = 408 | 6.5 mon (56.8%) 62.4% | 4 mL (n = 211) | 4 mL (n = 197) | RDAI ROH |
Quality assessment of the included literature
Summary of findings: | ||||||
3% Hypertonic Saline compared to 0.9% Normal Saline for ped bronchitis | ||||||
Patient or population: ped bronchitis Setting: Intervention: 3% Hypertonic Saline Comparison: 0.9% Normal Saline | ||||||
Outcomes | Anticipated absolute effects* (95% CI) | Relative effect(95% CI) | № of participants (studies) | Certainty of the evidence(GRADE) | Comments | |
Risk with 0.9% Normal Saline | Risk with 3% Hypertonic Saline | |||||
CSS | The mean CSS was −3.57 to 8.8 point | MD 0.93 point lower(1.23 lower to 0.62 lower) | – | 2010(11 RCTs) | ⨁⨁◯◯LOW a,b | |
RDAI | The mean RDAI was −4.7 to 5.32 point | MD 0.6 point lower(0.95 lower to 0.26 lower) | – | 1369(5 RCTs) | ⨁⨁⨁◯MODERATE a | |
LOS | The mean LOS was 1.4 to 7.49 days | MD 0.54 days lower(0.86 lower to 0.23 lower) | – | 2055(20 RCTs) | ⨁⨁◯◯LOW a,b | |
Rate of hospitalisation | 402 per 1000 | 342 per 1000(298 to 394) | RR 0.85(0.74 to 0.98) | 1710(8 RCTs) | ⨁⨁⨁◯MODERATE a | |
Rate of re-admission | 135 per 1000 | 97 per 1000(53 to 180) | RR 0.72(0.39 to 1.33) | 485(4 RCTs) | ⨁⨁⨁◯MODERATE a | |
Time of sleeping | The mean time of sleeping was 4.54 to 7.32 h | MD 1.72 h higher(0.43 lower to 3.88 higher) | – | 110(2 RCTs) | ⨁⨁◯◯LOW a,b | |
Frequency of wake-up in the night | The mean frequency of wake-up in the night was 3.11 to 9.28 time | MD 5.61 time lower(6.54 lower to 4.67 lower) | – | 110(2 RCTs) | ⨁⨁⨁◯MODERATE a |