Utility of Hypertonic Saline in the Management of Acute Bronchiolitis in Infants: A Randomised Controlled Study

Abstract

Background: Bronchiolitis is a common lower respiratory tract ailment usually affects infants. With few effective treatments, the health care cost of managing bronchiolitis is significant; Cochrane data base review has cited sufficient evidence regarding the usefulness of hypertonic saline in cystic fibrosis patients. Hypertonic saline has recently been given a trial in patients with acute bronchiolitis. We undertook the study to determine the efficacy and safety of hypertonic saline (3%) plus adrenaline nebulisation in bronchiolitis in infants and to compare it with normal saline (0.9%) plus adrenaline nebulisation.

Methods: One hundred consecutive patients attending Paediatrics Emergency at GMSH, Sector-16, Chandigarh between the age group of 2 to 12 months and admitted with clinical diagnosis of acute bronchiolitis were enrolled for the study.

Results: Baseline clinical symptoms and signs were comparable between the two groups. There was no significant difference found between 2 groups in relation to clinical signs (respiratory rate, RDAI, heart rate and SpO₂) pre and post nebulisation on day 1 as well as on day 2. The change in clinical parameters pre and post nebulisation in 2 groups was comparable. The mean SD length of stay in hospital in hypertonic saline and normal saline group was 3.92 1.72 days and 4.08 1.90 days respectively. There was no significant difference noted between two groups (P = 0.67).

Conclusion: Nebulisation with hypertonic saline plus adrenaline and normal saline plus adrenaline are equally effective in the treatment of acute bronchiolitis in infants. Nebulisation with hypertonic saline is a safe option of treatment in acute bronchiolitis in children.




doi: http://dx.doi.org/10.4021/ijcp96w