Efficacy Of Different Concentrations Of Nebulized Hypertonic Saline Solution Inhaling For Acute Bronchiolitis In Infants:A Network Meta-analysis

Background :Bronchiolitis is the most common lower respiratory tract infection in infants under 2 years old caused by respiratory virus infection.At present,there is no effective treatment,mainly symptomatic support therapy.The pathological changes of bronchitis are airway edema and increased mucus secretion caused by airway stenosis and obstruction,while hypertonic saline can absorb submucosal water,reduce mucosal edema,improve ciliary clearance,and theoretically treat bronchitis.The meta-analysis published by Cochrane in 2017 showed that hypertonic saline atomization can moderately reduce the length of hospital stay and improve the clinical severity score,affirming the efficacy of hypertonic saline atomization in the treatment of bronchitis.At present,3% hypertonic saline is most widely used.In addition,there are also observations on the efficacy of 5%,6% and 7% hypertonic saline in the treatment of bronchitis,but no conclusion has been reached on the optimal concentration.In this paper,we searched the RCT literature for the treatment of bronchitis with different concentrations of hypertonic saline for reticular meta-analysis,and hope to provide evidence for the optimal hypertonic saline concentration for the treatment of bronchitis.Objective: To assess the efficacy of Different concentrations of nebulized hypertonic saline solution as treatment in infants with bronchiolitis.Methods :We searched PubMed,EMBASE,Web of Science、Cochrane library,Cochrane clinical trials,CNKI,Wan Fang Chinese periodical Database and CBMdisc from the establishment of the database to January 2019。Two researchers independently assessed the potential risk of bias in included studies according to the Cochrane Collaboration’s recommendations.The analyses were performed using the Stata14.0Results:A total of 16 RCTs involving 1806 patients were included.The network meta-analysis showed that showed that 3% Hypertonic Saline Solutions was better than 0.9% normal saline in reducinging the length of hospital stay and the difference was statistically significant.For improving the clinical severity score,3% Hypertonic Saline Solutions and 5% Hypertonic Saline Solutions were better than 0.9% normal saline,and the difference was statistically significant,but there was no statistically significant difference between 3% and 5% Hypertonic Saline Solutions.Probability ranking according to SUCRA showed that: 3% Hypertonic Saline Solutions has the best effect in reducinging the length of hospital stay,while 5% Hypertonic Saline Solutions has the best effect in improving the clinical severity score.Conclusion:Based on the results of network meta-analysis and rank,3% Hypertonic Saline Solutions reduced the length of hospital stay.Both 3% and 5% Hypertonic Saline Solutions could improve the clinical severity score of the children,and the effect of 5% Hypertonic Saline Solutions was slightly better,but there was no significant statistical difference between the them.6% and 7% Hypertonic Saline Solutions did not show significant improvement in length of hospital stay and clinical severity score.