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Abstract
Background and aims No bronchodilator nebulised in saline has significantly proven to be more effective than saline alone. The efficacy of adrenaline in hypertonic saline solution has not yet been studied. To determine the utility of nebulised adrenaline in hypertonic saline solution to treat acute bronchiolitis in moderately ill hospitalised infants.
Methods Randomised, double-blind, controlled trial. 185 hospitalised infants (age 2.11 ± 2.23 months (mean ± SD)) with acute bronchiolitis received either nebulised 7 ml of 3% hypertonic saline solution with 3 mg of adrenaline (group SSH3%+A; n = 94) or with 3 ml of placebo (group SSH3%+P; n = 91), in addition to routine therapy. Nebulisations were initially administered every four hours and adjusted thereafter according to clinical response. Severe bronchiolitis and patients with serious risk factors were excluded. The principal outcome measure was hospital length of stay (LOS).
Results On an intention-to-treat basis, the 3%HHS+A group had a clinically relevant reduction in LOS (3.94 ± 1.88 days), compared with 4.88 ± 2.30 days in the 3%HHS+P group (p = 0.011). There were no statistically significant differences (p > 0.05) in: age (2.12 vs 2.10 months), male gender (50% vs 49%), atopic dermatitis (16.5% vs 9.6%), smoking parents (46% vs 36%), parental atopy (29% vs 31%), breastfeeding (56% vs 53%), number of siblings (0.68 vs 0.72), day care attendance (14% vs 10%), clinical scale at admission (5.24 vs 5.36) or percentage of positive RSV (60% vs 61%).
Conclusions The use of nebulised adrenaline in hypertonic saline solution may significantly reduce the length of stay among hospitalised infants with moderately ill acute bronchiolitis.
