Computerized Assessment of Wheezing in Children With Respiratory Syncytial Virus Bronchiolitis Before and After Hypertonic Saline Nebulization

Respir Care. 2015 Sep;60(9):1252-6. doi: 10.4187/respcare.03754. Epub 2015 Apr 28.

Abstract

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.

Keywords: RSV; bronchiolitis; digital acoustic monitoring; hypertonic saline; nebulization; wheeze.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acoustics
  • Auscultation / instrumentation
  • Auscultation / methods*
  • Bronchiolitis, Viral / complications*
  • Bronchiolitis, Viral / physiopathology
  • Child, Preschool
  • Diagnosis, Computer-Assisted
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Nebulizers and Vaporizers
  • Respiration
  • Respiratory Sounds / diagnosis*
  • Respiratory Sounds / drug effects
  • Respiratory Syncytial Virus Infections / complications*
  • Respiratory Syncytial Virus Infections / physiopathology
  • Respiratory Syncytial Virus, Human
  • Saline Solution, Hypertonic / administration & dosage
  • Severity of Illness Index
  • Symptom Assessment / methods*

Substances

  • Saline Solution, Hypertonic