Background and aims The use of nebulized adrenaline in the treatment of infants with acute bronchiolitis, has been related to increased cardiac rate. On the other hand, bronchoconstriction episodes requiring bronchodilators have been reported with the use of nebulized 3% hypertonic saline solution (3%SSH) without bronchodilators. We aimed to analyse the safety of nebulized adrenaline and nebulized 3% HSS in the management of infants hospitalised for acute moderate bronchiolitis.

Methods Randomised, double-blind, controlled trial. 185 hospitalised infants (2.11 ± 2.23 months (mean ± SD) received nebulized 3%HSS (7ml) either with 3 mg of adrenaline (group SSH3%+A; n = 94) or 3 ml of placebo (group SSH3%+P; n = 91), in addition to routine therapy. Nebulizations were initially administered every four hours and adjusted thereafter according to clinical response. The principal outcomes measures were cardiac rate (CR) and frequency rate (FR) up to the median of stay, nebulization requirements and need of transfer to the PICU.

Results There was not statistically significant differences in the cardiac frequency (p = 0.76, 0.48 and 0.73, respectively) and frequency rate (p = 0.88, 0.07 and 0.24, respectively) in 3 days of median of stay, nebulizations rates (p = 0.89), PICU’s admission (p = 1). No other adverse events were reported.

Conclusion In acute bronchiolitis for moderately ill hospitalised infants, nebulized adrenaline and nebulized 3%HSS are safe.