Aim To compare effect of Racemic Epinephrine (RE) and 3% Hypertonic saline (HS) nebulization on length of hospital stay (LOS) of infants with moderate bronchiolitis.
Method Infants with ‘moderate’ bronchiolitis presenting to Emergency Department (ED) were enrolled (October 2013 through March 2014) as per defined inclusion, exclusion criteria and severity assessment tool.1 Ethical approval was obtained. The enrolled infants were assigned RE or HS groups on alternate basis. All infants were monitored minimum every 4 h. Data was entered on Microsoft Excel and SPSS softwares to compare results.
Results Eighty infants with bronchiolitis presented to ED during study period. As per study criteria, 16 infants in HS group and 18 infants in RE group were enrolled. The demographics of the two groups were similar. During the study, one infant from RE group and three infants from HS group were excluded due to progression to severe disease.
Primary outcome In RE group, out of 17 remaining infants, the length of stay ranged between 18–160 h (Mean-45 ± 338 h). In HS group, out of remaining 13 infants, the length of stay ranged between 18.50–206 h (Mean-83 ± 556 h).
The mean ‘length of stay’ in group with Racemic epinephrine alone was significantly reduced (t-test, p-0.03) as compared to the Hypertonic saline group.
Secondary outcome No infant in RE group whereas 4 infants in HS group required oxygen therapy. One patient in RE group whereas 2 patients in HS required the intravenous fluids.
Conclusion Racemic Epinephrine nebulization as first-line medication reduces length of hospital stay in infants with moderate bronchiolitis.