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Randomised, Multicentre Clinical Trial Found That Hypertonic Saline Did Not Reduce the Length of Stay of Hospitalised
Sara Szupieńko-Bujak1, Karolina Bojarska-Cikoto2, Katarzyna Merdzik3
1Department of Paediatrics, St Hedwig of Silesia Hospital, Trzebnica, Poland.
Aim:
Bronchiolitis is a major cause of hospitalisation in young children, but the effectiveness of inhaled hypertonic saline remains unclear. We compared treating hospitalised infants with nebulised hypertonic saline or normal saline.
Method:
This multisite, double-blind RCT was conducted from 1 October 2023 to 1 April 2025 in four Polish paediatric units. Children from 5 weeks to 24 months, who had been hospitalised with mild-to-moderate bronchiolitis, were randomly assigned to receive nebulised 3% hypertonic saline or 0.9% normal saline until discharge. They were followed for 7 days.
Results:
The study comprised 181 children (55% male) with a mean age of 8.3 ± 6.3 months: 90 were randomised to hypertonic saline and 91 to normal saline. The median hospital stay was 2.68 (1.92-4.03) days in the hypertonic saline group and 2.79 (1.8-3.96) days in the normal saline group. The mean difference was -0.11 days (95% confidence interval -0.73 to 0.12, p = 0.3). No differences were observed in clinical severity scores between the groups. Readmissions only occurred in the normal saline group (5.9%).
Conclusion:
Hypertonic saline inhalation did not reduce the length of hospital stay or improve clinical severity scores in hospitalised children with bronchiolitis, but it was associated with a lower risk of rehospitalisation.
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