3% Hypertonic Saline Versus Normal Saline in Inpatient Bronchiolitis: A Randomized Controlled Trial

Area of Science:

• Pediatrics
• Respiratory Medicine
• Clinical Trials

Background:

• Bronchiolitis is a leading cause of infant hospitalization in the US.
• Current treatments for bronchiolitis primarily focus on supportive care.
• Effective therapies beyond supportive care for bronchiolitis are lacking.

Purpose of the Study:

• To compare the efficacy of nebulized 3% hypertonic saline (HS) versus nebulized normal saline (NS).
• To determine the effect of HS on length of hospital stay (LOS) in infants with bronchiolitis.
• To assess secondary outcomes including adverse events and readmission rates.

Main Methods:

• A prospective, randomized, double-blind, controlled trial was conducted.
• 227 infants under 12 months with bronchiolitis were enrolled.
• Infants received either nebulized 3% HS or 0.9% NS every 4 hours until discharge.

Main Results:

• Median length of stay was similar between the HS and NS groups (2.1 days vs 2.1 days, P = .73).
• Per-protocol analysis confirmed no significant difference in LOS.
• Seven-day readmission rates (4.3% vs 3.1%) and clinical worsening events (9% vs 8%) were comparable between groups.

Conclusions:

• Nebulized 3% hypertonic saline (HS) does not reduce length of hospital stay for infants hospitalized with bronchiolitis.
• Treatment with nebulized HS showed no significant difference in 7-day readmission rates compared to NS.
• Current evidence does not support the use of nebulized 3% HS over NS for hospitalized infants with bronchiolitis.