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Inpatient Hypertonic Saline

Bronchiolitis team recommendation: Based on moderate quality evidence the Bronchiolitis CPG Team recommends the use of hypertonic saline in children who have increased need for mucociliary clearance. Four moderate quality studies included in the meta-analysis found the use of hypertonic saline reduced hospital length of stay, significantly improved clinical severity scores on hospital day two and decreased the rate of re-admission.

Literature supporting this recommendation: Ten citations were located by the PubMed search, four were located by the CINAHL search and one Cochrane Database Systematic Reviews (CDSR) was located. Single studies identified in by the Bronchiolitis Team are included in the Zhang, et al.(2008) CDSR, and are not reported upon separately.

Critically Appraised Topic (CAT): Hypertonic Saline

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.