Uso de broncodilatadores versus solución salina hipertónica en el tratamiento de bronquiolitis aguda

Abstract

Bronchiolitis is an acute infectious pathology of the lower respiratory tract. It occurs mainly in children under two years of age and is an important cause of hospitalization in children worldwide. The management of this disease is still varied; bronchodilators, hypertonic saline solution (HSS), and general supportive measures are the most documented behaviors in the treatment.

Objective: Describe the usage of bronchodilators vs. hypertonic saline solution to treat severe bronchiolitis.

Methodology: Documentary type review with a sample of 12 articles acquired through PubMed and Scopus from 2017 to 2022. Results: The use of salbutamol in the ED decreased from 51.2% (95% CI: 46.6- 55.8%) in 2012 to 7.8% in 2018 (95% CI: 5.7%- 10.5%) (p < 0.001) in turn, the use of nebulized SSH evidenced a slight improvement of symptoms by 14% compared to nebulized saline at 0.9% (95% CI: -0.75 to -0.07; p = 0.02). HSS plus bronchodilators were shown to be more effective than placebo in reducing the duration of hospitalization (OR: 0.44; 95% CI: 0.23 to 0.84); there was no significant benefit compared to nebulized placebo in reducing admissions. Conclusions: Using bronchodilators is less recommended because it has not significantly reduced hospital stays, readmissions, and emergency room visits. Hypertonic saline and bronchodilators alone do not show clinical improvement, but in several studies, their association has shown a modest reduction in the hospital stay.