Effect of nebulized 3% hypertonic saline in the treatment of acute viral bronchiolitis in children.

Background: Bronchiolitis is the most common viral respiratory infections in children under 2 years. No effective Short-term or long-term treatment for bronchiolitis has been approved yet. Treatment is still supportive with oxygen, fluid and mechanical ventilation as necessary. Several studies have shown that 3% hypertonic saline improve immediate and longterm cleaning of small airways in these patients. This study aimed to compare the effects of 3% hypertonic saline with 0.9% saline in 2-24 month children with bronchiolitis. Materials and Methods: In a non-randomized clinical trial, 60 children aged 2 to 24 months with diagnosis of acute viral bronchiolitis were enrolled. Thirty children recieved 3% hypertonic saline with nebulizer as the treatment group and 30 children treated with nebulized normal saline 0.9% as the control group. In entrance, oxygen saturation (by pulse oximetry), respiratory rate, pulse rate and severity of disease were measured using a combination score (sum of Clinical Score (YALE Observation Scale) and RDAI (Respiratory Distress Assessment Index)) . The primary outcomes change in clinical score and hospitalization rate, and secondary outcomes were duration of hospitalization, need to oxygen therapy and recovery time from wheezing and cough. Results: Two groups were not different in terms of baseline variables, except age (8.9±4.9 months in the hypertonic saline group and 6.4 ± 4.6 months in normal saline group P=0.046). After the intervention, the difference in clinical severity between the hypertonic saline group (10.9±5.6) and normal saline (10.4±5.7) was not significant (adjusted for age P=0.77). The hospitalization rate was not significantly different in the two groups (60% vs 63.3%). Length of hospital stay, the need for oxygen therapy, number of days requiring intravenous fluid therapy and recovery time from cough and wheezing were not significantly different between two groups. Conclusion: It seems, 3% hypertonic saline does not have significant effect in reducing the severity of symptoms, rate of hospitalization and duration of hospitalization in 2-24 months children with viral bronchiolitis compared with normal saline 0.9%