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Comment & Response
November 2014

Nebulized Hypertonic Saline for Bronchiolitis—Reply

Author Affiliations
  • 1Division of Emergency Medicine, UCSF Benioff Children’s Hospital Oakland, Oakland, California
  • 2Division of Hospital Medicine, Children’s Hospital Los Angeles, Los Angeles, California
  • 3Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles
JAMA Pediatr. 2014;168(11):1078. doi:10.1001/jamapediatrics.2014.1707

In Reply We appreciate the perspective of Heaton et al and agree that results in the study by Wu et al recently published in JAMA Pediatrics need to be cautiously interpreted. Heaton et al expressed concern that only 1254 of 3447 patients were assessed for eligibility. This was a convenience sample. Investigators were available 70 hours per week and were able to assess eligibility for more than 40% of the entire study population. During the study period, the average length of stay at both sites was 3.57 days and the admission rate from the emergency department was approximately 42%, which is comparable with our study population. Our observed baseline Respiratory Distress Assessment Instrument (RDAI) scores range from 0 to 17 (the entire theoretical range of the measure), suggesting we captured both more and less severe patients. We feel confident that the study sample was representative of the overall cohort with the exception of predefined exclusion criteria.

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