Severe acute bronchiolitis in children: etiology, therapy, effectiveness of 3% hypertonic saline containing sodium hyaluronate

Abstract

Introduction. Acute bronchiolitis (АB) is a common  infection  in children  under  the  age of 2 years. In modern  clinical protocols, routine use of the studied drugs is not recommended. The effectiveness of a 3% hypertonic sodium chloride solution (HSCS) at vol.Аim. Тo study the etiology, risk factors, the therapy of acute care in children in intensive  care units (ICU), the effectiveness of inhalations with 3% HSCS with hyaluronate sodium (HS) in comparison  with therapy without  the inclusion of this drug.Materials and methods. The medical documentation of 54 patients with AB from January 2021 to January 2023 who were treated in the ICU was analyzed. An ambispective comparative study of the effectiveness of therapy  of 3% HSCS with HS AB was conducted  in comparison  with historical control.Results. Respiratory syncytial viral (RSV) etiology was established in 50% of patients. The most common risk factor for the disease was the  age younger than  3 months  (40.7%). The presence of risk factors for severe  course  of acute  respiratory  failure had an impact  on the average  bed-day and on the need  for respiratory  support  (p = 0.04), in addition  to which patients often  received drug therapy. There were no statistically significant differences  in the terms of hospitalization, the duration  of respiratory support depending on the appointment of 3% of HSCS with HS (p > 0.05), however, there  was an improvement in clinical and functional dynamics estimated by the modified clinical scale of Wood’s asthma  by the 2nd day of the disease.Conclusion. AB in ICU patients most  often  has RSV etiology, developing in the  presence of risk factors  for severe  course. The influence  of modern  guidelines for the treatment of AB in the ICU remains  controversial. The addition  of 3% HSCS with HS can improve the flow of AB.