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Comment & Response
January 2018

Hypertonic Saline and Acute Bronchiolitis—Reply

Author Affiliations
  • 1Service d'accueil des urgences pédiatriques, Necker-Enfants Malades University Hospital, Assistance Publique–Hôpitaux de Paris, Paris, France
  • 2Epidémiologie Clinique et Évaluation Économique Appliquées aux Populations Vulnérables, INSERM, Unité Mixte de Recherche 1123, Paris, France
  • 3Service de Pédiatrie, Antoine Béclère University Hospital, Assistance Publique–Hôpitaux de Paris, Clamart, France
  • 4Centre for Research in Epidemiology and Population Health, INSERM U1018, Villejuif, France
JAMA Pediatr. 2018;172(1):93-94. doi:10.1001/jamapediatrics.2017.3799

In Reply We thank Tanguay-Rioux et al for their careful reading and response, which allows us to clarify some points of our study. First, given the burden of acute bronchiolitis in infants, a treatment reducing hospital admission even by few percentage points should not be neglected. However, as stated by Ralston,1 demonstrating a slight efficacy in the experimental conditions of a randomized clinical trial does not imply a clinical pertinence in daily practice. For example, in a randomized clinical trial, patients are enrolled based on rigorous criteria, while a much larger phenotype of patients will be met in daily practice. The same applies to where and how the treatment is delivered. This point associated with adverse effects, and the cost of hypertonic saline (HS) nebulizations makes the clinical utility of such treatment very unlikely.

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