Nebulized Hypertonic Saline in the Treatment of Viral Bronchiolitis in Infants

Objective

To investigate the use of nebulized 3% hypertonic saline (HS) for treating viral bronchiolitis in moderately ill hospitalized infants by a prospective, randomized, double-blinded, controlled, multicenter trial.

Study design

A total of 96 infants (mean age, 4.7 months; range, 0.3 to 18 months) admitted to the hospital for treatment of viral bronchiolitis were recruited from 3 regional pediatric centers over 3 bronchiolitis seasons (December 2003 to May 2006). Patients were randomized to receive, in a double-blind fashion, repeated doses of nebulized 3% HS (treatment group) or 0.9% normal saline (NS; control group), in addition to routine therapy ordered by the attending physician. The principal outcome measure was hospital length of stay (LOS).

Results

On an intention-to-treat basis, the infants in the HS group had a clinically relevant 26% reduction in LOS to 2.6 ± 1.9 days, compared with 3.5 ± 2.9 days in the NS group (P = .05). The treatment was well tolerated, with no adverse effects attributable to the use of HS.

Conclusions

The use of nebulized 3% HS is a safe, inexpensive, and effective treatment for infants hospitalized with moderately severe viral bronchiolitis.

Abbreviations: ANOVA, Analysis of variance, HS, Hypertonic saline, KGH, Kingston General Hospital, LOS, Length of stay, NS, Normal saline, RDAI, Respiratory Distress Assessment Instrument, RSV, Respiratory syncytial virus, SaO₂, Oxygen saturation, SKMC, Sheikh Khalifa Medical City, VGH, Victoria General Hospital