Both strategies
use a short acting agent (usually nebulised epinephrine) to
decrease acute symptoms in combination with a potentially
disease modifying agent – dexamethasone to decrease risk of
hospitalisation or hypertonic saline to decrease hospital length
of stay. However, there remain uncertainties over the optimal
treatment strategy due to differences in the defi nition of bronchiolitis
in clinical trials. It is noteworthy that Reynolds and
Cook’s seminal review on bronchiolitis concluded that “carefully
controlled trials of various regimens certainly need to be
done”.