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Acute bronchiolitis is the most common cause of hospitalisation of infants. There is no specific therapy that provides consistent benefit. Nebulised hypertonic saline (HS) may be theoretically effective by improving mucociliary clearance, and reducing airway oedema and mucus viscosity. HS has been investigated as a therapeutic intervention in multiple studies, with inconsistent results. A 2013 Cochrane meta-analysis concluded that HS is a safe and effective treatment for acute bronchiolitis.1 This analysis of 11 randomised controlled trials (RCTs) (1090 infants) found a 1.15 days (95% CI 0.82 to 1.49) shorter mean hospital length of stay (LOS) in those treated with HS compared with normal saline (NS). Although initially promising, subsequent RCTs have shown that HS may not be as effective as previously …
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