BACKGROUND:We recently published preliminary evidence on the effectiveness of hypertonic saline in infants with viral bronchiolitis. OBJECTIVE:To further establish the efficacy of nebulized hypertonic saline in these infants. METHODS:In a continuing, second-year randomized, doubleblind controlled trial, an additional 41 infants (age 2.6 +/- 1 months) hospitalized with viral bronchiolitis were recruited during the winter of 2001-2002. The infants received inhalation of 1.5 mg epinephrine dissolved either in 4 ml normal (0.9%) saline (Group I, n=20) or 4 ml hypertonic (3%) saline (Group II, n=22). The therapy was repeated three times daily until discharge. Pooling our 2 years of experience (2000-2002), a total of 93 hospitalized infants with viral bronchiolitis were recruited; 45 were assigned to Group I and 48 to Group II. RESULTS:The clinical scores at baseline were 7.6 +/- 0.7 for Group I vs. 7.4 +/- 1.3 for Group II (P = NS). However, the clinical scores at days 1 and 2 after inhalation differed significantly between the two groups, invariably favoring Group II: 7 +/- 1 vs. 6.25 +/- 1.1 (P< 0.05), 6.45 +/- 1 vs. 5.35 +/- 1.35 (P< 0.05), respectively. Adding aerosolized 3% saline to 1.5 mg epinephrine reduced the hospitalization stay from 3.5 +/- 1.7 days in Group I to 2.6 +/- 1.4 in Group II (P< 0.05). The pooled data of both years revealed that adding 3% saline to the inhalation mixture decreased hospitalization stay from 3.6 +/- 1.6 to 2.8 +/- 1.3 days (P< 0.05). CONCLUSIONS:This second-year experience and our 2 year pooled data analysis strengthen the evidence that the combination of 3% saline/1.5 mg epinephrine benefits hospitalized infants with viral bronchiolitis.

译文

背景:我们最近发表了有关高渗盐水对病毒性毛细支气管炎婴儿的有效性的初步证据。
目的:进一步确定雾化高渗盐水对这些婴儿的疗效。
方法:在一项持续的第二年随机双盲对照试验中,在2001-2002年冬季另外招募了41例病毒性毛细支气管炎住院婴儿(年龄2.6 /-1个月)。婴儿吸入1.5 mg肾上腺素,溶于4 ml生理盐水(0.9%)(I组,n = 20)或4 ml高渗(3%)盐水(II组,n = 22)。每天重复治疗3次直至出院。总结我们2年的经验(2000-2002年),共招募了93例住院治疗的病毒性毛细支气管炎婴儿。 I组分配了45个,II组分配了48个。
结果:第一组的基线临床评分为7.6 /-0.7,第二组为7.4 /-1.3(P = NS)。然而,两组在吸入后第1天和第2天的临床评分差异显着,无一例外地倾向于第二组:7 /-1 vs. 6.25 /-1.1(P <0.05),6.45 /-1 vs. 5.35 /-1.35 (P <0.05)。在1.5 mg肾上腺素中添加3%气雾剂可使住院时间从I组的3.5 /-1.7天减少至II组的2.6 /-1.4(P <0.05)。两年的汇总数据显示,向吸入混合物中添加3%的盐水可使住院时间从3.6 /-1.6天减少到2.8 /-1.3天(P <0.05)。
结论:这第二年的经验和我们两年的汇总数据分析,进一步证明了3%生理盐水/1.5 mg肾上腺素的组合有益于住院的病毒性毛细支气管炎婴儿。

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