Summary of findings 2. Magnesium sulphate compared with hypertonic saline for acute bronchiolitis in children.
| Magnesium sulphate versus hypertonic saline for acute bronchiolitis in children | ||||||
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Patient or population: children up to 12 months old with acute bronchiolitis Settings: single‐centre, emergency department, paediatric intensive care unit and wards Intervention: magnesium sulphate Comparison: hypertonic saline | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Hypertonic saline | Magnesium sulphate | |||||
| Time to recovery | ‐ | ‐ | ‐ | ‐ | ‐ | Outcome not measured |
| Mortality | ‐ | ‐ | ‐ | ‐ | ‐ | Outcome not measured |
| Adverse events | ‐ | ‐ | ‐ | ‐ | ‐ | Outcome not measured |
| Duration of hospital stay | The mean (SD) duration of hospital stay in the hypertonic saline group was 3.2 days (1.0) | The mean duration of hospital stay in the magnesium sulphate group was 3.2 days (0.28 lower to 0.28 higher) | MD 0.00 (‐0.28 to 0.28) |
220 (1 RCT) |
⊕⊝⊝⊝ very lowa | |
|
Clinical severity score (CSS) (RDAI score; range 0 to 17; higher = poorer outcomes) measured at 0 to 24 hours after treatment |
‐ | ‐ | ‐ | ‐ | ‐ | Outcome not measured |
|
Clinical severity score (CSS) (RDAI score; range 0 to 17; higher = poorer outcomes) measured at 25 to 48 hours after treatment |
The mean (SD) CSS at 48 hours in the hypertonic saline group was 3.7 points (1.8) | The mean CSS at 48 hours in the magnesium sulphate group was 0.10 points higher (0.39 lower to 0.59 higher) | MD 0.10 (‐0.39 to 0.59) | 220 (1 RCT) | ⊕⊝⊝⊝ very lowa | |
| Hospital re‐admission within 30 days of discharge | ‐ | ‐ | ‐ | ‐ | ‐ | Outcome not measured |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; MD: mean difference; SD: standard deviation; RCT: randomised controlled trial; RADI: respiratory distress assessment instrument | ||||||
| GRADE Working Group grades of evidence High quality. Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality. Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality. Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality. We are very uncertain about the estimate. | ||||||
aWe downgraded the quality of the evidence to very low for indirectness and very serious imprecision (1 study, small sample size).