Nasal saline irrigation in children: A study of compliance and tolerance

Jeffe, Jill S.; Bhushan, Bharat; Schroeder, James W.

doi:10.1016/j.ijporl.2011.12.022

Cited by 59 publications

(53 citation statements)

References 11 publications

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“…Recently, a meta-analysis of 10 randomized controlled trials has provided evidence for the role of short and long courses of SNI in AR adults and children as a complementary therapy for improving nasal symptoms and QoL, and for decreasing drug consumption [7]. Both normal saline solution (NSS) and buffered normal saline have been shown to be associated with good compliance and tolerance [8]. Conversely, nasal burning/irritation was reported for buffered hypertonic saline (BHS), despite its efficacy in reducing nasal symptoms in children with AR [9] and adults with rhinosinusitis [10].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Buffered Hypertonic Saline Nasal Irrigation for Nasal Symptoms in Children with Seasonal Allergic Rhinitis: A Randomized Controlled Trial

Malizia¹,

Fasola²,

Ferrante³

et al. 2017

Int Arch Allergy Immunol

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Background: Saline nasal irrigation is labelled as an add-on treatment in patients with allergic rhinitis (AR). The primary aim of this study was to compare the efficacy of 21-day use of buffered hypertonic saline (BHS) versus normal saline solution (NSS) on reducing nasal symptoms in children with seasonal AR (SAR). Comparing their efficacy on nasal cytology counts (NCC), quality of life, and sleep quality was the secondary aim. Methods: In this 21-day,open-label, randomized controlled study, 36 SAR children (aged 6-13 years) with a Total 5 Symptom Score (T5SS) ≥5 received twice-daily BHS or NSS delivered through a nasal douche. Efficacy measures were least square mean changes (LSmc) in T5SS, NCC, Paediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ), and Pittsburgh Sleep Quality Index (PSQI) scores. Results: BHS improved the T5SS total score to a greater extent than NSS (LSmc -6.45 vs. -5.45, p < 0.001). Concerning NCC, BHS significantly reduced the scores of neutrophils (LSmc -0.76, p = 0.004) and eosinophils (LSmc -0.46, p = 0.018), while NSS did not. Similarly, only BHS yielded a significant improvement in the PRQLQ score (LSmc -0.57, p = 0.009), whereas the improvement in PSQI score was comparable between the BHS (LSmc -0.77, p = 0.025) and NSS (LSmc -1.39, p < 0.001) groups. Overall, BHS was well tolerated. Conclusions: In children with SAR, BHS is effective in improving nasal symptoms and NCC, with an associated beneficial effect on quality of life.

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Section: Introductionmentioning

confidence: 99%

Efficacy of Buffered Hypertonic Saline Nasal Irrigation for Nasal Symptoms in Children with Seasonal Allergic Rhinitis: A Randomized Controlled Trial

Malizia¹,

Fasola²,

Ferrante³

et al. 2017

Int Arch Allergy Immunol

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“…All of these studies showed that NSI is safe and well tolerated because there were no severe adverse events and only a minority of children had to discontinue the treatment because of poor tolerance [3-8]. It has also been shown that the procedure is quite inexpensive and reduces the use of prescription and over-the-counter medications, and therefore have a substantial impact not only on medical costs, but also on antibiotic pressure and the associated antibiotic resistance [9]. …”

Section: Introductionmentioning

confidence: 99%

Nasal saline irrigation in preschool children: a survey of attitudes and prescribing habits of primary care pediatricians working in northern Italy

Marchisio

Picca²,

Torretta

et al. 2014

Ital J Pediatr

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BackgroundIt has been shown that nasal saline irrigation (NSI) alone can be effective in children with infectious and/or allergic respiratory problems, but no study has assessed the awareness or clinical use of NSI among practising pediatricians. The main aim of this study was to evaluate the use of NSI in pre-school children by primary care pediatricians working in northern Italy.MethodsNine hundred randomly selected National Health Service primary care pediatricians with an e-mail address were sent an e-mail asking whether they were willing to respond to a questionnaire regarding the use of NSI. The 870 who answered positively were sent an anonymous questionnaire by post and e-mail that had 17 multiple-choice items.ResultsCompleted questionnaires were received from 860 of the 870 primary care pediatricians (98.8%). NSI was used by almost all the respondents (99.3%), although with significant differences in frequency. It was considered both a prophylactic and a therapeutic measure by most of the respondents (60.3%), who prescribed it every day for healthy children and more frequently when they were ill. Most of the primary care pediatricians (87%) indicated an isotonic solution as the preferred solution, and the most frequently recommended administration devices were a nasal spray (67.7%) and bulb syringe (20.6%). Most of the pediatricians (75.6%) convinced parents to use NSI by explaining it could have various beneficial effects, and two-thirds (527/854; 61.7%) thought that most of the parents agreed about the importance of NSI. Analysis of possible associations between NSI prescribing behaviour and the demographic data revealed an associations with age and gender, with pediatricians aged <50 years prescribing NSI more frequently than their older counterparts (p < 0.01), and females prescribing NSI more frequently than males (p < 0.01).ConclusionsIn Northern Italy, most primary care pediatricians prescribe NSI for both the prophylaxis and therapy of upper respiratory tract problems in pre-school children. However, many aspects of the procedure are not clarified, and this reduces parental compliance. Given the medical and economic advantages of NSI, this situation should be changed as soon as possible.

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“…Tolerance is judged by parents and the evaluation is mainly derived from the opinion of the operator instead of the patient’s judgment. A detailed evaluation of tolerance and compliance of NI in pediatrics has been performed by Jeffe et al, who prescribed NI to 57 children aged 2–16 years after parents were instructed on how to rinse [41]. Each NI consisted of 100 mL of room temperature saline solution irrigated through each nostril for different periods according to parents’ judgment.…”

Section: Tolerability and Safety Of Nasal Irrigation (Ni)mentioning

confidence: 99%

Nasal Irrigation: An Imprecisely Defined Medical Procedure

Principi

Esposito

2017

IJERPH

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Nasal irrigation (NI) is an old practice of upper respiratory tract care that likely originated in the Ayurvedic medical tradition. It is used alone or in association with other therapies in several conditions—including chronic rhinosinusitis and allergic rhinitis—and to treat and prevent upper respiratory tract infections, especially in children. However, despite it being largely prescribed in everyday clinical practice, NI is not included or is only briefly mentioned by experts in the guidelines for treatment of upper respiratory tract diseases. In this review, present knowledge about NI and its relevance in clinical practice is discussed to assist physicians in understanding the available evidence and the potential use of this medical intervention. Analysis of the literature showed that NI seems to be effective in the treatment of several acute and chronic sinonasal conditions. However, although in recent years several new studies have been performed, most of the studies that have evaluated NI have relevant methodologic problems. Only multicenter studies enrolling a great number of subjects can solve the problem of the real relevance of NI, and these studies are urgently needed. Methods for performing NI have to be standardized to determine which solutions, devices and durations of treatment are adequate to obtain favorable results. This seems particularly important for children that suffer a great number of sinonasal problems and might benefit significantly from an inexpensive and simple preventive and therapeutic measure such as NI.

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Nasal saline irrigation in children: A study of compliance and tolerance

Cited by 59 publications

References 11 publications

Efficacy of Buffered Hypertonic Saline Nasal Irrigation for Nasal Symptoms in Children with Seasonal Allergic Rhinitis: A Randomized Controlled Trial

Efficacy of Buffered Hypertonic Saline Nasal Irrigation for Nasal Symptoms in Children with Seasonal Allergic Rhinitis: A Randomized Controlled Trial

Nasal saline irrigation in preschool children: a survey of attitudes and prescribing habits of primary care pediatricians working in northern Italy

Nasal Irrigation: An Imprecisely Defined Medical Procedure

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