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Can the Efficacy of Hypertonic Saline in Bronchiolitis Truly Be Assessed With a Short-term Primary Outcome?

Daniel Horner, MBBS, BSc, MRCP, MCEM; Thomas Bartram, MBChB, MRCS, MCEM; Rachel Jenner, MBChB, FRCSEd, FCEM; Rosemary Morton, MBChB, FRCS, FRCP,  FFAEM, FRCPCH
Arch Pediatr Adolesc Med. 2010;164(4):395. doi:10.1001/archpediatrics.2010.36.
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Grewal et al1 should be congratulated for their recent study concerning the use of 3% hypertonic saline in the treatment of bronchiolitis. It is refreshing to see such a well-conducted pediatric trial based in the emergency department (ED). We would, however, make several points regarding the methodology of the study and raise concerns about the ultimate message. We believe that the efficacy of the treatment must be looked at in the wider context of the patient journey.

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