A randomized trial of nebulized 3% hypertonic saline with salbutamol in the treatment of acute bronchiolitis in hospitalized infants.
OBJECTIVE
Acute bronchiolitis is a common disorder of infants that often results in hospitalization. Apart from supportive care, no therapy has been shown to influence the course of the disease, except for a possible effect of nebulized hypertonic saline (HS). To determine whether this does have beneficial effects on length of stay in hospital or on severity scores, we undertook a double-blind, randomized, controlled trial in a pediatric department of a Portuguese hospital.


METHODS
Previously healthy infants, younger than 12 months, hospitalized with mild-to-moderate acute viral bronchiolitis were randomized to receive either nebulized 3% (hypertonic, HS) or 0.9% (normal, NS) saline during their entire hospital stay. Primary endpoints were: length of hospital stay and severity scores on each day of hospitalization. Need for supplemental oxygen, further add-on medications and adverse effects were also analyzed.


RESULTS
Sixty-eight patients completed the study (HS: 33; NS: 35). The median length of hospital stay did not differ between groups: HS: 5.6 ± 2.3 days; NS: 5.4 ± 2.1 days (P = 0.747). We found no difference between groups in severity scores from day 1 to day 4. There were no differences in need for supplemental oxygen or add-on medications. Patients in HS group had significantly more cough (46% vs. 20%, P = 0.025) and rhinorrhoe (58% vs. 31%, P = 0.30).


CONCLUSIONS
This study does not support the use of nebulized HS over NS in therapy of hospitalized children with mild-to-moderate acute viral bronchiolitis.
Hospital Cuf Descobertas, Lisboa, Portugal.
Pedro
P
Flores
Hospital Cuf Descobertas, Lisboa, Portugal.
Ana Luisa
AL
Mendes
Hospital Cuf Descobertas, Lisboa, Portugal.
Ana S
AS
Neto
D000280:Administration, Inhalation; D000420:Albuterol / Q000008:administration & dosage*; D001988:Bronchiolitis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002673:Child, Hospitalized; D003371:Cough / Q000209:etiology* / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D000068104:Infant Health; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D009330:Nebulizers and Vaporizers; D011174:Portugal / Q000453:epidemiology; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D001993:Bronchodilator Agents; D012462:Saline Solution, Hypertonic; D000420:Albuterol
Pneumonia; TB; asthma & early wheeze; evidence-based medicine & outcomes; viral