Computerized Assessment of Wheezing in Children With Respiratory Syncytial Virus Bronchiolitis Before and After Hypertonic Saline Nebulization.
BACKGROUND
Studies suggest an effect of nebulized hypertonic saline solution on air-flow limitation in subjects with respiratory syncytial virus (RSV) bronchiolitis, but results are based on subjective scores of clinical severity and are not clear. In this observational study, we used a noninvasive computerized tool to quantify wheezing before and after nebulization with hypertonic saline in children admitted for RSV infection.


METHODS
Twenty-seven children (≤ 24 months old) admitted to the pediatric ward of the Medical Center Leeuwarden with polymerase chain reaction-confirmed RSV bronchiolitis were included. Subjects were simultaneously assessed both clinically and by computerized acoustic monitoring before and 15 min after treatment with nebulized hypertonic saline solution.


RESULTS
Clinical assessment, defined by the Respiratory Distress Assessment Instrument score, did not change after nebulization (n = 27, 5.0 vs 4.7, P = .17). Computerized acoustic monitoring showed no improvement in wheezing (n = 27, 3.4% vs 2.0%, P = .05) or inspiration/expiration ratio (0.85 vs 0.85, P = .93) after nebulization.


CONCLUSIONS
Hypertonic saline nebulization does not improve air flow, as assessed by both clinical and computerized acoustic scores, in children admitted for RSV.
Department of Pediatrics tina.faber@znb.nl.
Tina E
TE
Faber
Department of Pediatrics.
Arvid Wa
AW
Kamps
Department of Pediatrics.
Machtelt H
MH
Sjoerdsma
Department of Pediatrics.
Stephanie
S
Vermeulen
Department of Clinical Epidemiology, MCL Academy, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
Nic Jgm
NJ
Veeger
Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Louis J
LJ
Bont
D000162:Acoustics; D001314:Auscultation / Q000295:instrumentation / Q000379:methods*; D001990:Bronchiolitis, Viral / Q000150:complications* / Q000503:physiopathology; D002675:Child, Preschool; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009330:Nebulizers and Vaporizers; D012119:Respiration; D012135:Respiratory Sounds / Q000175:diagnosis* / Q000187:drug effects; D018357:Respiratory Syncytial Virus Infections / Q000150:complications* / Q000503:physiopathology; D018113:Respiratory Syncytial Virus, Human; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage; D012720:Severity of Illness Index; D063189:Symptom Assessment / Q000379:methods*
D012462:Saline Solution, Hypertonic
RSV; bronchiolitis; digital acoustic monitoring; hypertonic saline; nebulization; wheeze