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SABRE: a multicentre randomised control trial of nebulised hypertonic saline in infants hospitalised with acute bronchiolitis

Everard, Mark L.; Hind, Daniel; Ugonna, Kelechi; Freeman, Jennifer; Bradburn, Mike; Cooper, Cindy L.; Cross, Elizabeth; Maguire, Chin; Cantrill, Hannah; Alexander, John; McNamara, Paul S.; Sprange, Kirsty

SABRE: a multicentre randomised control trial of nebulised hypertonic saline in infants hospitalised with acute bronchiolitis Thumbnail


Authors

Mark L. Everard

Daniel Hind

Kelechi Ugonna

Jennifer Freeman

Mike Bradburn

Cindy L. Cooper

Elizabeth Cross

Chin Maguire

Hannah Cantrill

John Alexander

Paul S. McNamara



Abstract

Aim: Acute bronchiolitis is the commonest cause for hospitalisation in infancy. Supportive care remains the cornerstone of current management and no other therapy has been shown to influence the course of the disease. It has been suggested that adding nebulised hypertonic saline to usual care may shorten the duration of hospitalisation. To determine whether hypertonic saline does have beneficial effects we undertook an open, multi-centre parallel-group, pragmatic RCT in ten UK hospitals.

Methods: Infants admitted to hospital with a clinical diagnosis of acute bronchiolitis and requiring oxygen therapy were randomised to receive usual care alone or nebulised 3% hypertonic saline (HS) administered 6-hourly. Randomisation was within 4 h of admission. The primary outcome was time to being assessed as ‘fit’ for discharge with secondary outcomes including time to discharge, incidence of adverse events together with follow up to 28 days assessing patient centred health related outcomes.

Results: A total of 317 infants were recruited to the study. 158 infants were randomised to HS (141 analysed) and 159 to standard care (149 analysed). There was no difference between the two arms in time to being declared fit for discharge (hazard ratio: 0−95, 95% CI: 0.75−1.20) nor to actual discharge (hazard ratio: 0.97, 95% CI: 0.76−1.23). There was no difference in adverse events. One infant in the HS group developed bradycardia with desaturation.

Conclusion: This study does not support the use of nebulised HS in the treatment of acute bronchiolitis over usual care with minimal handlings.

ClinicalTrials.gov registration number NCT01469845.

[The Nottingham author on this record (Kirsty Sprange) was part of the Trial Management Management Group.]

Journal Article Type Article
Acceptance Date Sep 29, 2014
Online Publication Date Nov 11, 2014
Publication Date Nov 11, 2014
Deposit Date Mar 6, 2018
Publicly Available Date Sep 27, 2018
Print ISSN 0040-6376
Electronic ISSN 1468-3296
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 69
Issue 12
DOI https://doi.org/10.1136/thoraxjnl-2014-205953
Public URL https://nottingham-repository.worktribe.com/output/1126270
Publisher URL https://thorax.bmj.com/content/69/12/1105
PMID 00034501