Magnesium sulphate for treating acute bronchiolitis in children up to two years of age

Chandelia, Sudha; Kumar, Dinesh; Chadha, Neelima; Jaiswal, Nishant

doi:10.1002/14651858.cd012965.pub2

Cited by 9 publications

(12 citation statements)

References 52 publications

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“…All 27 trials had random sequence generation and provided adequate information on incomplete outcomes, selective reporting, and other bias. [21–47] Twenty studies reported sufficient information on allocation concealment, [3–32,36,38–45,47] and 18 RCTs elaborated the blinding of participants and personnel clearly. [21–23,25–28,30–32,36,39–45,47] All trials described blinding of outcome assessments, except for 10 studies, [24,28,29,33–35,37,38,40,46] which provided insufficient information.…”

Section: Resultsmentioning

confidence: 99%

3% nebulized hypertonic saline versus normal saline for infants with acute bronchiolitis: A systematic review and meta-analysis of randomized controlled trials

Zhang

Liu

et al. 2022

Medicine

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Background: This study evaluated the efficacy and safety of 3% nebulized hypertonic saline (NHS) in infants with acute bronchiolitis (AB).Methods: We systematically searched the PUBMED, EMBASE, Cochrane Library, China National Knowledge Infrastructure Database, WANFANG, and VIP databases from inception to June 1, 2022. We included randomized controlled trials comparing NHS with 0.9% saline. Outcomes included the length of hospital stay (LOS), rate of hospitalization (ROH), clinical severity score (CSS), rate of readmission, respiratory distress assessment instrument, and adverse events. RevMan V5.4 software was used for statistical analysis.Results: A total of 27 trials involving 3495 infants were included in this study. Compared to normal saline, infants received 3% NHS showed better outcomes in LOS reduction (MD = −0.60, 95% CI [−1.04, −0.17], I 2 = 92%, P = .007), ROH decrease (OR = 0.74, 95% CI [0.59, 0.91], I 2 = 0%, P = .005), CSS improvement at day 1 (MD = −0.79, 95% CI [−1.23, −0.34], I 2 = 74%, P < .001), day 2 (MD = −1.26, 95% CI [−2.02, −0.49], I 2 = 91%, P = .001), and day 3 and over (MD = −1.27, 95% CI [−1.92, −0.61], I 2 = 79%, P < .001), and respiratory distress assessment instrument enhancement (MD = −0.60, 95% CI [−0.95, −0.26], I 2 = 0%, P < .001). No significant adverse events related to 3% NHS were observed. Conclusion:This study showed that 3% NHS was better than 0.9% normal saline in reducing LOS, decreasing ROH, improving CSS, and in enhancing the severity of respiratory distress. Further studies are needed to validate these findings.Abbreviations: AB = acute bronchiolitis, AEs = adverse events, CI = confidence interval, CSS = clinical severity score, LOS = length of hospital stay, MD = mean difference, NHS = nebulized hypertonic saline, NS = normal saline, RCTs = randomized controlled trials, RDAI = respiratory distress assessment instrument, ROH = rate of hospitalization, ROR = rate of readmission, RR = risk ratio.

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Section: Resultsmentioning

confidence: 99%

3% nebulized hypertonic saline versus normal saline for infants with acute bronchiolitis: A systematic review and meta-analysis of randomized controlled trials

Zhang

Liu

et al. 2022

Medicine

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“…Una revisión que incluyó 4 estudios controlados concluyó que no existe suficiente evidencia para establecer la eficacia y seguridad del sulfato de magnesio para el tratamiento de niños con BA, sin existir diferencias en el tiempo de recuperación, duración de ventilación mecánica y estadía en la UCI (51). Se requieren estudios controlados para evaluar el tiempo de recuperación, alta hospitalaria y eventos adversos.…”

Section: Sulfato De Magnesiounclassified

Actualizacion De La Bronquiolitis Aguda

Vega-Briceño¹

2021

Neumol Pediatr

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La bronquiolitis aguda es una condición respiratoria frecuente en los niños menores de 2 años. Representa la principal causa de hospitalización infantil y se caracteriza por la presencia de sibilancias asociada a signos de una infección respiratoria alta. El agente etiológico más común es el virus respiratorio sincicial. Existe una falta de consenso con respecto a su definición clínica; y por ello, su tratamiento varía en todo el mundo. El diagnóstico es clínico, sin necesidad de emplear laboratorio o imágenes en forma rutinaria. Diversas revisiones han demostrado que los broncodilatadores, adrenalina, corticoides y antibióticos, entre otros, carecen de eficacia por lo que no se sugiere su empleo. El tratamiento sigue siendo de soporte, mediante la administración de oxígeno y manteniendo una adecuada hidratación. Cuando no se logra disminuir el trabajo respiratorio o corregir la hipoxemia se puede utilizar la presión positiva en la vía aérea para prevenir y controlar la insuficiencia respiratoria. Este artículo desarrolla una breve revisión de las principales características clínicas, epidemiológicas, radiológicas, así como algunos de los diferentes tratamientos publicados en las últimas dos décadas.

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“…1 The most frequent causative pathogen, respiratory syncytial virus (RSV), is estimated to cause over 30 million cases and over 3 million hospitalizations in children under 5 years of age annually. 2 Previous studies have shown that the following treatments have been ineffective in treating infant bronchiolitis: bronchodilators, 3 chest physiotherapy, 4 systematic or inhaled glucocorticoids, 5 magnesium sulfate, 6 and antibiotics. 7 The current treatment strategy focuses on breathing support.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have shown that the following treatments have been ineffective in treating infant bronchiolitis: bronchodilators, 3 chest physiotherapy, 4 systematic or inhaled glucocorticoids, 5 magnesium sulfate, 6 and antibiotics 7 . The current treatment strategy focuses on breathing support.…”

Section: Introductionmentioning

confidence: 99%

Helium–oxygen in bronchiolitis—A systematic review and meta‐analysis

Kuitunen

Kiviranta

Sankilampi

et al. 2022

Pediatric Pulmonology

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Introduction Bronchiolitis is common reason for infant hospitalization. The aim of our systematic review and meta‐analysis was to evaluate helium–oxygen (heliox) in bronchiolitis. Methods We screened 463 studies, assessed 22 of them, and included six randomized controlled trials. Primary outcomes were the need for continuous positive airway pressure (CPAP) or intubation, hospitalization duration, and change in the modified Woods Clinical Asthma Scale (M‐WCAS). We calculated mean differences with 95% confidence intervals (CIs) for continuous outcomes and risk ratios (RRs) for dichotomous outcomes. Results Six studies (five double‐ and one single‐blinded) with 560 infants were included. The risk of bias was high in one, moderate in four, and low in one. The RR for the need for CPAP (three studies) was 0.87 (CI: 0.56–1.35), and for intubation (four studies) was 1.39 (CI: 0.53–3.63), heliox compared to air–oxygen. The hospital stay (four studies) was 0.25 days longer (CI: −0.22 to 0.71) in the heliox group. The mean decrease in M‐WCAS from the baseline (three studies) was 1.90 points (CI: 1.46–2.34) greater in the heliox group. Conclusion We found low‐quality evidence that heliox does not reduce the need for CPAP, intubation, or length of hospitalization for bronchiolitis. Based on the M‐WCAS scores, heliox seems to relieve respiratory distress symptoms rapidly after its initiation. The included studies had high heterogeneity in their methods and included relatively mild cases of bronchiolitis. A larger randomized controlled trial with more severe cases of bronchiolitis with enough power to analyze the need for intubation is needed in the future.

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Magnesium sulphate for treating acute bronchiolitis in children up to two years of age

Abstract: Magnesium sulphate for treating acute bronchiolitis in children up to two years of age.

Cited by 9 publications

References 52 publications

3% nebulized hypertonic saline versus normal saline for infants with acute bronchiolitis: A systematic review and meta-analysis of randomized controlled trials

3% nebulized hypertonic saline versus normal saline for infants with acute bronchiolitis: A systematic review and meta-analysis of randomized controlled trials

Actualizacion De La Bronquiolitis Aguda

Helium–oxygen in bronchiolitis—A systematic review and meta‐analysis

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