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Related Experiment Video

Updated: Feb 16, 2026

Bronchoalveolar Lavage BAL for Research; Obtaining Adequate Sample Yield
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Nebulised hypertonic saline solution for acute bronchiolitis in infants.

Linjie Zhang1, Raúl A Mendoza-Sassi, Claire Wainwright

  • 1Faculty of Medicine, Federal University of Rio Grande, Rua Visconde Paranaguá 102, Centro, Rio Grande, RS, Brazil, 96201-900.

The Cochrane Database of Systematic Reviews
|December 22, 2017
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Summary

Nebulised hypertonic saline may shorten hospital stays and reduce hospitalisation rates for infants with acute viral bronchiolitis. However, the evidence quality is low to moderate, warranting cautious interpretation of these findings.

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Area of Science:

  • Pediatric Pulmonology
  • Critical Care Medicine
  • Respiratory Infections

Background:

  • Acute viral bronchiolitis in infants is characterized by airway edema and mucus plugging.
  • Nebulized hypertonic saline (≥ 3%) is investigated for its potential to alleviate these pathological changes and reduce airway obstruction.

Purpose of the Study:

  • To evaluate the efficacy of nebulized hypertonic saline in managing acute bronchiolitis in infants.
  • To assess its impact on hospital length of stay and hospitalization rates.

Main Methods:

  • A systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
  • Inclusion criteria: infants under 24 months with acute bronchiolitis, treated with nebulized hypertonic saline versus 0.9% saline or standard care.
  • Primary outcomes: length of hospital stay for inpatients, and hospitalization rate for outpatients/emergency department patients.

Main Results:

  • Nebulized hypertonic saline significantly reduced mean hospital stay for inpatients (MD -0.41 days, low-quality evidence).
  • It also lowered post-inhalation clinical scores in the first three days of treatment (low-quality evidence).
  • A 14% reduction in hospitalization risk was observed for outpatients/emergency department patients (moderate-quality evidence).

Conclusions:

  • Nebulized hypertonic saline offers a modest benefit in reducing hospital length of stay and improving clinical scores in infants with bronchiolitis.
  • It may decrease hospitalization risk for outpatients and emergency department patients.
  • The overall quality of evidence is assessed as low to moderate.