When two trials conflict: bronchiolitis and hypertonic saline

The editors of JAMA Pediatrics must have been flummoxed when they received two papers at the same time describing the same interventional trial, with completely different results. Both were trials comparing 3% with 0.9% nebulised saline in bronchiolitis, and both were conducted in the emergency departments (EDs) of US children's hospitals. The editors took the brave decision to publish them simultaneously with an accompanying editorial. Both trials recruited infants under two years presenting to ED with a first episode of clinically diagnosed bronchiolitis, and both excluded those with pre-existing cardio-respiratory conditions. Both were double-blind and both used hospital admission rates and a clinical scoring system, either Respiratory Distress Assessment Instrument (RDAI) or Respiratory Assessment Change Score (RACS), as outcomes. The larger trial, from California, randomised about 400 infants; all were pre-medicated with a beta-2 agonist, nebulised albuterol, and then given up to three 4 ml doses of saline (Wu S...
Source: Archives of Disease in Childhood - Category: Pediatrics Tags: Miscellanea Source Type: research