Impact of Hyaneb in the management of severe acute bronchiolitis in pediatric patients: a single-center retrospective study

Abstract Background To determine the impact of Hyaneb (7% hypertonic saline and 0.1% hyaluronic acid) on severe acute bronchiolitis management in pediatric patients. The aim of this study is to evaluate the possible benefits and safety of Hyaneb in managing severe acute bronchiolitis. Methods This retrospective observational study was conducted in a tertiary healthcare center. The investigation included patients aged < 2 years who were admitted to the pediatric intensive care unit (PICU) of the Clínico San Carlos Hospital. Patients were excluded if they had a radiological diagnosis of pneumothorax on admission, infection by other microorganisms, bronchiolitis for > 5 days, need for respiratory or hemodynamic support with extracorporeal techniques, or known allergies or intolerance to any Hyaneb compounds. We evaluated the potential benefit and safety of using Hyaneb in severe acute bronchiolitis between 2019 and 2020 by comparing two groups of patients: one that received Hyaneb and the other that did not. Results A total of 49 children were included in the study, and 51.7% received Hyaneb. The median age was 1 month (interquartile range [IQR] 1.5–2.0), and the median weight was 4.7 ± 1.3 kg. Patient history included premature birth in 10% of the sample population. The results were not significant for the length of stay in the PICU and the respiratory support score ( p = 0.114 and p = 0.06, respectively). However, there was a significant difference ( p = 0.047) in the use of adrenaline rescue between the groups. These data were no longer significant when adjusted for age, Wood Downes scale, and weight ( p = 0.056). Conclusions Using nebulized Hyaneb seems safe in patients less than a month old and weighing less than 5 kg. A reduction in PICU stay or respiratory support length could not be confirmed.