Hypertonic saline for acute viral bronchiolitis: Take the evidence with a grain of Salt

摘要

Fifty years ago, Reynolds and Cook [1] wrote, "Oxygen is vitally important in bronchiolitis and there is little convincing evidence that any other therapy is consistently or even occasionally useful." Their claim is once again supported by the new trial on hypertonic saline published in this issue of the European Respiratory Journal (ERJ) [2]. Acute viral bronchiolitis (AVB) is the most common lower respiratory tract infection in infancy. It is caused by respiratory viruses, typically by respiratory syncytial virus [3]. Although only 1-2% of children are hospitalised, AVB accounts for a large proportion of paediatric emergency visits and hospitalisations during winter months [4]. An effective treatment would reduce the number of hospitalisations, hospital length of stay (LOS) and their corresponding health costs.