Network Meta-Analysis Comparing the Efficacy of Therapeutic Treatments for Bronchiolitis in Children

作者：Guo, Caili^*; Sun, Xiaomin; Wang, Xiaowen; Guo, Qing; Chen, Dan

来源：Journal of Parenteral and Enteral Nutrition, 2018, 42(1): 186-195.

DOI：10.1002/jpen.1030

• children
• bronchiolitis
• treatment efficacy
• network meta-analysis

Background: This study aims to compare placebo (PBO) and 7 therapeutic regimens-namely, bronchodilator agents (BAs), hypertonic saline (HS), BA +/- HS, corticosteroids (CS), epinephrine (EP), EP +/- CS, and EP +/- HS-to determine the optimal bronchiolitis treatment. Methods: We plotted networks using the curative outcome of several studies and specified the relations among the experiments by using mean difference, standardized mean difference, and corresponding 95% credible interval. The surface under the cumulative ranking curve (SUCRA) was used to separately rank each therapy on clinical severity score (CSS) and length of hospital stay (LHS). Results: This network meta-analysis included 40 articles from 1995 to 2016 concerning the treatment of bronchiolitis in children. All 7 therapeutic regimens displayed no significant difference to PBO with regard to CSS in our study. Among the 7 therapies, BA performed better than CS. As for LHS, EP and EP +/- HS had an advantage over PBO. Moreover, EP and EP +/- HS were also more efficient than BA. The SUCRA results showed that EP +/- CS is most effective, and EP +/- HS is second most effective with regard to CSS. With regard to LHS, EP +/- HS ranked first, EP +/- CS ranked second, and EP ranked third. Conclusions: We recommend EP +/- CS and EP +/- HS as the first choice for bronchiolitis treatment in children because of their outstanding performance with regard to CSS and LHS.

• 出版日期2018-1
• 单位郑州市儿童医院