Hypertonic Saline as Add on Therapy in Preschool Children With Acute Wheezing Attack.
Status:
Completed
Trial end date:
2011-07-01
Target enrollment:
Participant gender:
Summary
To investigate the efficacy of adding Inhaled Hypertonic Saline treatment (HS) for 1-6 year
old children with "asthmatic" attack presenting to Emergency Department (ED).
Background: In 1-6 year old children, the most common causes of acute exacerbations of asthma
requiring urgent medical care are viral respiratory infections. Most of these children are
not atopic and often do not respond very well to bronchodilators and steroids. Thus novel
treatments are needed.
HS is considered an effective and safe treatment for infants with acute viral bronchiolitis
(Cochrane 2008). HS acts in the airways in several mechanisms: HS re-hydrates secretions and
improving mucus rheology, reduce edema of the airway wall by absorbing water from the mucosa
and submucosa, causes sputum induction and cough, which can help to clear the sputum out of
the bronchi, stimulates cilial beat via the release of prostaglandin E2, breaks the ionic
bonds within the mucus gel, thereby lowering the viscosity and elasticity of the mucus
secretion.
It is estimated that all the above HS responding elements may play a role in this viral
induce wheezing. The above mentioned theoretical benefits provide the rationale for the
possible treatment of viral induced acute wheezing ("asthma") attack with nebulized HS in
young pre-school children presenting to the Pediatric Emergency Unit with acute (mostly viral
induced) wheezing.
Therefore, the purpose of the present study is to 1. Investigate the addition of frequently
nebulized 5% HS/albuterol combination to standard therapy of acute asthmatic episodes
presenting to the emergency department (ED) in preschool children in a prospective,
randomized, double-blind, controlled fashion.