{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:22:30Z","timestamp":1792074150932,"version":"4.4.0"},"reference-count":14,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,6,1]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Most acute wheezing episodes in preschool children are associated with rhinovirus. Rhinovirus decreases extracellular adenosine triphosphate levels, leading to airway surface liquid dehydration. This, along with submucosal edema, mucus plaques, and inflammation, causes failure of mucus clearance. These preschool children do not respond well to available treatments, even oral steroids. This calls for pro\u2013mucus clearance and prohydration treatments such as hypertonic saline in wheezing preschool children.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Randomized, controlled, double-blind study. Forty-one children (mean age 31.9 \u00b1 17.4 months, range 1\u20136 years) presented with wheezing to the emergency department were randomized after 1 albuterol inhalation to receive either 4 mL of hypertonic saline 5% (HS) (n = 16) or 4 mL of normal saline (NS) (n = 25), both with 0.5 mL albuterol, twice every 20 minutes in the emergency department and 4 times a day thereafter if hospitalized. The primary outcome measured was length of stay (LOS) and the secondary outcomes were admission rate (AR) and clinical severity score.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n The LOS was significantly shorter in the HS than in the NS group: median 2 days (range 0\u20136) versus 3 days (range 0\u20135) days (P = .027). The AR was significantly lower in the HS than the NS group: 62.2% versus 92%. Clinical severity score improved significantly in both groups but did not reach significance between them.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Using HS inhalations significantly shortens LOS and lowers AR in preschool children presenting with an acute wheezing episode to the emergency department.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2011-3376","type":"journal-article","created":{"date-parts":[[2012,5,21]],"date-time":"2012-05-21T20:21:46Z","timestamp":1337631706000},"page":"e1397-e1403","source":"Crossref","is-referenced-by-count":18,"title":["Hypertonic Saline and Acute Wheezing in Preschool Children"],"prefix":"10.1542","volume":"129","author":[{"given":"Dorit","family":"Ater","sequence":"first","affiliation":[{"name":"Pediatric Pulmonary Unit, and"},{"name":"Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanita","family":"Shai","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonary Unit, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bat-El","family":"Bar","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonary Unit, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Fireman","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonary Unit, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Tasher","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; and"},{"name":"Pediatric Infectious Disease Unit,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilan","family":"Dalal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; and"},{"name":"Emergency Department, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ami","family":"Ballin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; and"},{"name":"Pediatric Department, Wolfson Medical Centre, Holon, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avigdor","family":"Mandelberg","sequence":"additional","affiliation":[{"name":"Pediatric Pulmonary Unit, and"},{"name":"Department of Pediatrics, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2012,6,1]]},"reference":[{"issue":"4","key":"2021120903485411900_B1","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1183\/09031936.00002108","article-title":"Definition, assessment and treatment of wheezing disorders in preschool children: an evidence-based approach.","volume":"32","author":"Brand","year":"2008","journal-title":"Eur Respir J"},{"issue":"3 Pt 1","key":"2021120903485411900_B2","first-page":"879","article-title":"Lower airways inflammation during rhinovirus colds in normal and in asthmatic subjects.","volume":"151","author":"Fraenkel","year":"1995","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"2021120903485411900_B3","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1056\/NEJMe0808951","article-title":"Practice imperfect\u2014treatment for wheezing in preschoolers.","volume":"360","author":"Bush","year":"2009","journal-title":"N Engl J Med"},{"issue":"4","key":"2021120903485411900_B4","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1056\/NEJMoa0804897","article-title":"Oral prednisolone for preschool children with acute virus-induced wheezing.","volume":"360","author":"Panickar","year":"2009","journal-title":"N Engl J 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