Original ArticleNebulized 5% or 3% Hypertonic or 0.9% Saline for Treating Acute Bronchiolitis in Infants
Section snippets
Methods
We conducted a double-blinded, randomized, parallel-group clinical trial to compare the efficacy and safety of 5% and 3% hypertonic saline versus 0.9% (normal) saline for the treatment of acute bronchiolitis. The study was conducted between September 2007 and December 2008 in the short-stay unit of the Pediatric Emergency Center of Hamad General Hospital, the only pediatric emergency facility in Qatar. The center serves an average of 200 000 patients annually and manages 42 beds in a short-stay
Results
A total of 187 previously healthy infants diagnosed with viral bronchiolitis, median age 3.1 months (range, 9 days to 14.7 months), were enrolled in the study. Sixteen infants were excluded from the analysis; 9 should have been excluded from enrollment (4 born at ≤34 weeks' gestational age, 2 with a history of apnea with cyanosis before enrollment, 1 with previously known severe laryngomalacia, and 2 who had received steroids within 24 hours before enrollment), 1 infant was enrolled twice in
Discussion
In our study group, nebulization with 5% hypertonic saline proved superior to 0.9% saline for improving the bronchiolitis severity score in patients with viral bronchiolitis in the early treatment setting, and possibly superior to 3% saline as well. If our results are confirmed, we believe this simple, inexpensive, easily applied, safe, and apparently effective treatment could be generalized for use worldwide in clinics, infirmaries, and hospitals caring for pediatric patients. Bronchiolitis
References (19)
- et al.
Nebulized 3% hypertonic saline treatment in hospitalized infants with viral bronchiolitis
Chest
(2003) - et al.
Nebulized 3% hypertonic saline solution treatment in ambulatory children with viral bronchiolitis decreases symptoms
Chest
(2002) Bronchiolitis: inpatient focus
Pediatr Clin North Am
(2005)Respiratory syncytial virus
- et al.
Risk of primary infection and reinfection with respiratory syncytial virus
Am J Dis Child
(1986) - et al.
Substantial variability in community respiratory syncytial virus season timing
Pediatr Infect Dis J
(2003) - et al.
Direct medical costs of bronchiolitis hospitalizations in the United States
Pediatrics
(2006) Respiratory syncytial virus and parainfluenza virus
N Engl J Med
(2001)- et al.
Respiratory syncytial virus
Pediatr Rev
(1998)
Cited by (74)
Improving Prehospital Management of Children With Respiratory Distress
2018, Clinical Pediatric Emergency MedicineCitation Excerpt :There is some evidence to support a trial of this therapy on children who are admitted, as it may reduce length of admission.39 The AAP Clinical Practice Guidelines recommend this not be used in children in the emergency department as small studies show conflicting results.40,41 Nebulized racemic epinephrine has been used to treat children with both croup and bronchiolitis.
IV Magnesium Sulfate for Bronchiolitis: A Randomized Trial
2017, ChestCitation Excerpt :These may have been chance findings, but the significant P values cause us concern that magnesium treatment during infirmary care in this subset might have masked worse bronchiolitis in patients who were therefore discharged too soon or may somehow prolong disease course in these patients. It is also possible that the bronchiolitis treatment practice in our center of using 5% hypertonic saline nebulization in all patients and systemic dexamethasone in selected patients6,7,11 might have led to a disadvantageous drug interaction in the magnesium intervention group. As with other “negative studies,” we may have failed to identify a benefit from IV magnesium in a patient subgroup because of the limited sample size.
The clinical use of hypertonic saline/salbutamol in treatment of bronchiolitis
2016, Pediatria PolskaMustard Lung: Diagnosis and Treatment of Respiratory Disorders in Sulfur-Mustard Injured Patients
2016, Mustard Lung: Diagnosis and Treatment of Respiratory Disorders in Sulfur-Mustard Injured PatientsNebulised hypertonic saline solution for acute bronchiolitis in infants
2023, Cochrane Database of Systematic Reviews
Supported by Hamad Medical Corporation which employs all of the physicians except B.D., who also worked at Hamad. The authors declare no conflicts of interest.
Registered at clinicaltrials.gov: ID# NCT01016249.