Original articleNebulized Hypertonic Saline in the Treatment of Viral Bronchiolitis in Infants
Section snippets
Patients
Infants up to age 18 months who were admitted to the hospital for the treatment of moderately severe viral bronchiolitis were eligible for study. The diagnosis of moderately severe bronchiolitis required a history of a preceding viral upper respiratory infection, the presence of wheezing or crackles on chest auscultation, plus either an oxygen saturation (SaO2) of <94% in room air or significant respiratory distress as measured by a Respiratory Distress Assessment Instrument (RDAI)34 score of
Study Population
A total of 96 previously well infants (mean age, 4.7 ± 4.2 months; range, 10 days to 18 months) with viral bronchiolitis were enrolled from 3 centers during the bronchiolitis seasons from December 2003 to May 2006. Thirty-two infants were enrolled from the 2 Canadian sites (VGH and KGH), and 64 infants were enrolled from SKMC. Forty-seven infants were randomized to the HS treatment group, and 49 were randomized to the NS control group. Five infants (2 from the HS group and 3 from the NS group)
Discussion
This study demonstrates that inhaled 3% HS is an effective treatment for infants up to age 18 months hospitalized with viral bronchiolitis. Repeated inhalations of nebulized HS reduced the LOS by approximately 1 day, from 3.5 ± 2.9 to 2.6 ± 1.9 days. This is a clinically relevant benefit with the potential for widespread impact on the treatment of bronchiolitis.
The infants that we studied came from a population that was geographically and ethnically very diverse. Nevertheless, these infants
References (43)
- et al.
Bronchiolitis
Lancet
(2006) - et al.
Hospitalization for lower respiratory tract illness in infants: variation in rates among counties in New York State and areas within Monroe Counties
J Pediatr
(1995) - et al.
New approaches to respiratory infections in children: bronchiolitis and croup
Emer Med Clin North Am
(2002) - et al.
Efficacy of oral dexamethasone in outpatients with acute bronchiolitis
J Pediatr
(2002) - et al.
Oral prednisolone in the acute management of children age 6 to 35 months with viral respiratory infection-induced lower airway disease: a randomized, placebo-controlled trial
J Pediatr
(2003) Oral prednisolone in the acute management of children age 6 to 35 months with viral respiratory infection–induced lower airway disease: a randomized, placebo-controlled trial
J Pediatr
(2004)- et al.
Nebulized 3% hypertonic saline solution treatment in ambulatory children with viral bronchiolitis decreases symptoms
Chest
(2002) - et al.
A randomized controlled trial of the effectiveness of nebulized therapy with epinephrine compared with albuteral and saline in infants hospitalized for acute viral bronchiolitis
J Pediatr
(2002) - et al.
A clinical pathway for bronchiolitis is effective in reducing readmission rates
J Pediatr
(2005) - et al.
A randomized trial comparing the efficacy of epinephrine with salbutamol in the treatment of acute bronchiolitis
J Pediatr
(1995)
Induced sputum: comparison between isotonic and hypertonic saline solution in patients with asthma
Chest
Nebulized 3% hypertonic saline solution treatment in hospitalized infants with bronchiolitis
Chest
Inhalation of hypertonic saline as a bronchial challenge in children with mild asthma and normal children
J Allergy Clin Immunol
Inhalation bronchoprovocation in children
Immunol Clin North Am
Epidemiology of acute lower respiratory disease in children
N Engl J Med
Respiratory syncytial virus–associated lower respiratory illnesses: possible influence of other agents
Pediatr Infect Dis
RSV and parainfluenza virus
N Engl J Med
Direct medical costs of bronchiolitis hospitalizations in the United States
Pediatrics
Diagnosis and management of bronchiolitis
Pediatrics
Bronchiolitis
Pediatr Rev
Pathological changes in viral infections of the lower respiratory tract in children
J Clin Pathol
Cited by (136)
Systematic review of instruments aimed at evaluating the severity of bronchiolitis
2018, Paediatric Respiratory ReviewsViral bronchiolitis
2017, The LancetComparison of Hypertonic Saline and Salbutamol Nebulization in Children with Acute Bronchiolitis in a Tertiary Care Hospital
2023, Pakistan Paediatric JournalNebulised hypertonic saline solution for acute bronchiolitis in infants
2023, Cochrane Database of Systematic ReviewsDisorder of nose breathing in children: causes, consequences, modern views on correction and prevention (literature review)
2023, Ukrainian Journal of Perinatology and Pediatrics
Supported by the Queen Alexandra Foundation for Children, British Columbia, Canada; Vancouver Island Health Authority, Youth and Maternal Programme, British Columbia, Canada; and an Ontario Thoracic Society block term grant.
No reprint requests are available from the authors.