Hypertonic saline/epinephrine treatment in hospitalized infants with viral bronchiolitis reduces hospitalization stay: 2 years experience.
BACKGROUND
We recently published preliminary evidence on the effectiveness of hypertonic saline in infants with viral bronchiolitis.


OBJECTIVE
To further establish the efficacy of nebulized hypertonic saline in these infants.


METHODS
In a continuing, second-year randomized, doubleblind controlled trial, an additional 41 infants (age 2.6 +/- 1 months) hospitalized with viral bronchiolitis were recruited during the winter of 2001-2002. The infants received inhalation of 1.5 mg epinephrine dissolved either in 4 ml normal (0.9%) saline (Group I, n=20) or 4 ml hypertonic (3%) saline (Group II, n=22). The therapy was repeated three times daily until discharge. Pooling our 2 years of experience (2000-2002), a total of 93 hospitalized infants with viral bronchiolitis were recruited; 45 were assigned to Group I and 48 to Group II.


RESULTS
The clinical scores at baseline were 7.6 +/- 0.7 for Group I vs. 7.4 +/- 1.3 for Group II (P = NS). However, the clinical scores at days 1 and 2 after inhalation differed significantly between the two groups, invariably favoring Group II: 7 +/- 1 vs. 6.25 +/- 1.1 (P< 0.05), 6.45 +/- 1 vs. 5.35 +/- 1.35 (P< 0.05), respectively. Adding aerosolized 3% saline to 1.5 mg epinephrine reduced the hospitalization stay from 3.5 +/- 1.7 days in Group I to 2.6 +/- 1.4 in Group II (P< 0.05). The pooled data of both years revealed that adding 3% saline to the inhalation mixture decreased hospitalization stay from 3.6 +/- 1.6 to 2.8 +/- 1.3 days (P< 0.05).


CONCLUSIONS
This second-year experience and our 2 year pooled data analysis strengthen the evidence that the combination of 3% saline/1.5 mg epinephrine benefits hospitalized infants with viral bronchiolitis.
Tal
Guy
G
Pediatric Pulmonary Unit, Wolfson Medical Center, Holon, Israel.
Cesar
Karine
K
Oron
Anat
A
Houri
Sion
S
Ballin
Ami
A
Mandelberg
Avigdor
A
D000280:Administration, Inhalation; D001990:Bronchiolitis, Viral / Q000188:drug therapy* / Q000453:epidemiology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000639:trends*; D008297:Male; D009330:Nebulizers and Vaporizers; D012189:Retrospective Studies; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D012462:Saline Solution, Hypertonic; D004837:Epinephrine