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Updated: Dec 9, 2025
Methodology for Sputum Induction and Laboratory Processing
Published on: December 17, 2017
Exploring the efficacy of using hypertonic saline for nebulizing treatment in children with bronchiolitis: a
Chia-Wen Hsieh1,2, Chiehfeng Chen3,4,5,6, Hui-Chuan Su1,2
1Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Insights
Nebulized hypertonic saline (HS) effectively reduces respiratory distress and hospital stays in infants with acute bronchiolitis. This systematic review confirms HS as a beneficial treatment for this common childhood illness.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Evidence-Based Medicine
Background:
- Acute bronchiolitis is a common respiratory infection in infants under two years old, often causing dyspnea.
- Inhaled hypertonic saline (HS) has demonstrated potential in reducing airway edema associated with bronchiolitis.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy and safety of nebulized HS for treating children diagnosed with acute bronchiolitis.
Main Methods:
- A comprehensive literature search was performed across major databases (Cochrane Library, PubMed, EMBASE, Airiti Library) for relevant randomized controlled trials.
- Data from 32 publications, including 4186 children, were analyzed using RevMan 5.3 to calculate pooled risk ratios and mean differences.
Main Results:
- Nebulized HS significantly reduced respiratory distress severity, as measured by the Clinical Severity Score and Respiratory Distress Assessment Instrument.
- The HS group experienced a significant decrease in hospital stay duration by an average of 0.54 days compared to the control group.
Conclusions:
- Nebulization with 3% saline solution is an effective treatment for acute bronchiolitis, leading to reduced symptom severity and shorter hospitalizations.
- Further large-scale, rigorous randomized controlled trials are recommended to solidify these findings.
Background:
Inhaled hypertonic saline (HS) has shown benefit in decreasing airway edema in acute bronchiolitis which is the most common lower respiratory infection resulting in dyspnea among infants under 2 years old. The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of HS in the implementation of treatment with nebulized HS among children with bronchiolitis.
Methods:
A systematic literature search was conducted using Cochrane Library, PubMed, EMBASE and Airiti Library (Chinese Database) for randomized controlled trials from inception to July 2019. We calculated pooled risk ratios (RR), mean difference (MD) and 95% CI using RevMan 5.3 for meta-analysis.
Results:
There were 4186 children from 32 publications included. Compared to the control group, the HS group exhibited significant reduction of severity of respiratory distress, included studies used the Clinical Severity Score (n = 8; MD, - 0.71; 95% CI, - 1.15 to - 0.27; I2 = 73%) and full stop after Respiratory Distress Assessment Instrument (n = 5; MD, - 0.60; 95% CI, - 0.95 to - 0.26; I2 = 0%) for evaluation respectively. Further, the HS group decreased the length of hospital stay 0.54 days (n = 20; MD, - 0.54; 95% CI, - 0.86 to - 0.23; I2 = 81%).
Conclusions:
We conclude that nebulization with 3% saline solution is effective in decreasing the length of hospital stay and the severity of symptoms as compared with 0.9% saline solution among children with acute bronchiolitis. Further rigorous randomized controlled trials with large sample size are needed.
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