title: 3% Hypertonic Saline Versus Normal Saline in Inpatient Bronchiolitis: A Randomized Controlled Trial.
abstract: OBJECTIVE
  Bronchiolitis, the most common reason for hospitalization in children younger than 1 year in the United States, has no proven therapies effective beyond supportive care. We aimed to investigate the effect of nebulized 3% hypertonic saline (HS) compared with nebulized normal saline (NS) on length of stay (LOS) in infants hospitalized with bronchiolitis.
  
  
  METHODS
  We conducted a prospective, randomized, double-blind, controlled trial in an urban tertiary care children's hospital in 227 infants younger than 12 months old admitted with a diagnosis of bronchiolitis (190 completed the study); 113 infants were randomized to HS (93 completed the study), and 114 to NS (97 completed the study). Subjects received 4 mL nebulized 3% HS or 4 mL 0.9% NS every 4 hours from enrollment until hospital discharge. The primary outcome was median LOS. Secondary outcomes were total adverse events, subdivided as clinical worsening and readmissions.
  
  
  RESULTS
  Patient characteristics were similar in groups. In intention-to-treat analysis, median LOS (interquartile range) of HS and NS groups was 2.1 (1.2-4.6) vs 2.1 days (1.2-3.8), respectively, P = .73. We confirmed findings with per-protocol analysis, HS and NS groups with 2.0 (1.3-3.3) and 2.0 days (1.2-3.0), respectively, P = .96. Seven-day readmission rate for HS and NS groups were 4.3% and 3.1%, respectively, P = .77. Clinical worsening events were similar between groups (9% vs 8%, P = .97).
  
  
  CONCLUSIONS
  Among infants admitted to the hospital with bronchiolitis, treatment with nebulized 3% HS compared with NS had no difference in LOS or 7-day readmission rates.
authors.affiliation: Division of Pediatric Hospital Medicine, Department of Pediatrics, alysilve@montefiore.org.
authors.forename: Alyssa H
authors.initials: AH
authors.lastname: Silver
authors.affiliation: Division of Pediatric Hospital Medicine, Department of Pediatrics.
authors.forename: Nora
authors.initials: N
authors.lastname: Esteban-Cruciani
authors.affiliation: Division of Pediatric Hospital Medicine, Department of Pediatrics.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Azzarone
authors.affiliation: Division of Pediatric Hospital Medicine, Department of Pediatrics.
authors.forename: Lindsey C
authors.initials: LC
authors.lastname: Douglas
authors.affiliation: Division of Pediatric Hospital Medicine, Department of Pediatrics.
authors.forename: Diana S
authors.initials: DS
authors.lastname: Lee
authors.affiliation: Division of Pediatric Hospital Medicine, Department of Pediatrics, Department of Pediatrics, Steven and Alexandra Cohen Children's Medical Center at North Shore-LIJ Health System, New Hyde Park, New York; and.
authors.forename: Sheila
authors.initials: S
authors.lastname: Liewehr
authors.affiliation: Division of Pediatric Hospital Medicine, Department of Pediatrics.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Nazif
authors.affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York;
authors.forename: Ilir
authors.initials: I
authors.lastname: Agalliu
authors.affiliation: Department of Pharmacy, Arnold and Marie Schwartz College of Pharmacy, Long Island University, Brooklyn, New York Department of Pharmacy, The Children's Hospital at Montefiore, and.
authors.forename: Susan
authors.initials: S
authors.lastname: Villegas
authors.affiliation: Division of Pediatric Hospital Medicine, Department of Pediatrics.
authors.forename: Hai Jung H
authors.initials: HJ
authors.lastname: Rhim
authors.affiliation: Division of Pediatric Hospital Medicine, Department of Pediatrics.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Rinke
authors.affiliation: Division of Pediatric Hospital Medicine, Department of Pediatrics.
authors.forename: Katherine
authors.initials: K
authors.lastname: O'Connor
mesh_terms: D000280:Administration, Inhalation; D001988:Bronchiolitis / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007223:Infant; D007297:Inpatients; D007552:Isotonic Solutions / Q000627:therapeutic use*; D007902:Length of Stay; D008297:Male; D009330:Nebulizers and Vaporizers; D011446:Prospective Studies; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D012965:Sodium Chloride / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D007552:Isotonic Solutions; D012462:Saline Solution, Hypertonic; D012965:Sodium Chloride