The Effect of Hypertonic Saline in Treatment of Moderate Bronchiolitis in Children

Alaa Jumaah Nasrawi


Background: Airway oedema and mucus plugging are the predominant pathological features in infants with acute viral bronchiolitis. Nebulized hypertonic saline (HS) solution may reduce these pathological changes and decrease airway obstruction. Aim: To assess the effects of nebulized hypertonic (3%) saline solution in infants with acute viral Bronchiolitis of moderate severity. Methods: This study was conducted in Al Zahraa teaching hospital for maternity and pediatric in the period between December 2013 till November 2014 at which 165 patients with acute viral bronchiolitis were included. The inclusion criteria were; Infants aged ≤18 months presented with a prodromal history consistent with viral upper respiratory tract infection followed by wheezing and/or crackles on auscultation. Patients were excluded from the study if they have the following criteria: born at ≤ 34 weeks’ gestation, previous history of wheezing, steroid use within 48 hours of presentation, history of apnea within 24 hours before presentation, oxygen saturation ≤85% on room air at the time of recruitment, history of a diagnosis of chronic lung disease, congenital heart disease, or immunodeficiency, consolidation or atelectasis on a chest X-Ray and infants with bronchiolitis severity score <4 or > 8. Result: We found that nebulized 3% HS decreases bronchiolitis severity score after 12h of treatment and its effect subsided after more than 48 h. In regard to hospital stay, the study shows a decrease in mean of hospital stay length from 42.2 to 36.3 h. Conclusion: Nebulization with 3% hypertonic saline is safe, can be widely generalized, and may be superior to current treatment for early outpatient treatment of bronchiolitis. Recommendation: Planning for a multicenter trial to explore the clinical benefit of this therapy with a large sample size is essential.

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