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