Nebulized hypertonic saline/salbutamol solution treatment in hospitalized children with mild to moderate bronchiolitis.

BACKGROUND: The objective of this study was to determine the efficacy and safety of nebulized 3% hypertonic saline solution and salbutamol in the treatment of mild to moderate bronchiolitis. METHODS: In a randomized controlled trial, 93 infants with mild to moderate bronchiolitis were divided into two groups. The infants received inhalation of 2.5 mg (0.5 mL) salbutamol dissolved in either 4.0 mL normal (0.9%) saline (control group, n= 43) or 4.0 mL hypertonic (3%) saline (treatment group, n= 50). The therapy was repeated three times daily until discharge. Cough, wheezing, pulmonary physical signs, and the length of hospital stay were recorded. RESULTS: Wheezing remission time was 3.8 + or - 1.1 days in the control group and 2.7 + or - 0.9 days in the treatment group (P < 0.01). Cough remission time was 6.3 + or - 0.9 days in the control group and 5.3 + or - 0.8 days in the treatment group (P < 0.01). The moist crackles disappeared at 5.4 + or - 0.8 days in the treatment group versus 6.2 + or - 0.9 days in the control group (P < 0.01). Furthermore, the average length of hospital stay decreased from 7.4 + or - 1.5 days in the control group to 6.0 + or - 1.2 days in the treatment group (P < 0.01). No obvious adverse effects were observed. CONCLUSIONS: Inhalation of nebulized 3% hypertonic saline solution and salbutamol is a safe and effective therapy for patients with mild to moderate bronchiolitis.

Effects of prednisolone on refractory mycoplasma pneumoniae pneumonia in children.

OBJECTIVES: To prospectively evaluate prednisolone treatment in children with refractory Mycoplasma pneumonia pneumonia (MPP). METHODS: Fifty-eight refractory children with MPP were enrolled to receive either azithromycin combined with prednisolone (treatment group, n = 28) or azithromycin alone (control group, n = 30). Temperature, respiratory symptoms and signs were examined at the time of study entry and every 8 hr after enrollment, infiltration absorption, atelectasis resolution, pleural effusion disappearance, and serum ferritin and LDH levels were assessed on seventh day after enrollment. RESULTS: All patients in treatment group achieved defervescence during 8-48 hr after enrollment versus no patient in the control group. The mean duration of hypoxemia was 1.9 ± 0.9 days in treatment group and 2.7 ± 1.1 days in the control group (P < 0.05), and the dyspnea resolved time was 1.5 ± 0.7 days and 2.9 ± 0.6 days (P < 0.05), respectively. Seven days after enrollment, 80% of patients in treatment group showed infiltration absorption versus 21.4% in control group (P < 0.05); the figures for atelectasis resolution were 71.4% versus 12.5% (P < 0.05), and for pleural effusion disappearance 88.9% versus 20.0% (P < 0.05). The serum ferritin and LDH level was lower in the treatment than that in control group (P < 0.05). CONCLUSIONS: Azithromycin combined with prednisolone is a better treatment for children with refractory MPP than azithromycin alone.

Vitamin A deficiency and wheezing.

BACKGROUND: Vitamin A deficiency may increase the responsiveness of the respiratory tract and increase the risk of respiratory tract infection, resulting in airway obstruction and wheezing. This study aimed to investigate the relation between vitamin A deficiency and infant wheezing. METHODS: Three ml venous blood samples were collected from 331 hospitalized children who suffered from wheezing to determine the serum vitamin A concentration and the relationship between vitamin A and some causative factors of wheezing. RESULTS: The severity of vitamin A deficiency was related to the course of wheezing. In the persistent wheezing group, 14 patients (34.1%) were diagnosed as having severe vitamin A deficiency and 16 patients (39%) having moderate vitamin A deficiency; among the acute wheezing group, 18 patients (16.4%) were diagnosed as having severe vitamin A deficiency and 32 patients (29%) having moderate vitamin A deficiency. Comparison of the two groups revealed that there was a significantly higher rate of moderate and severe vitamin A deficiency in the persistent wheezing group than in the acute wheezing group (P<0.01). The severity of vitamin A deficiency was related to the infants' wheezing severity. Severe vitamin A deficiency was found in 24 patients (47%) in the severe wheezing group and 8 (8%) in the mild and moderate wheezing groups. The rate of severe vitamin A deficiency was significantly higher in patients with severe wheezing than in those with mild and moderate wheezing (P<0.01). CONCLUSIONS: Serum vitamin A deficiency could be commonly found in infants with wheezing. The severity of vitamin A deficiency might be related to the course of wheezing and the infants' wheezing severity.