Comparative Efficacy of Nebulized 3% Hypertonic Saline versus 0.9% Normal Saline in Children with Acute Bronchiolitis

  • Khandaker Tarequl Islam Junior Consultant, Department of Pediatrics, Shaheed Suhrawardy Medical College Hospital, Dhaka
  • Abid Hossan Mollah Professor, Department of pediatrics, BIRDEM, Dhaka
  • Abdul Matin Professor, Department of pediatrics, Dhaka Medical College, Dhaka
  • Mahmuda Begum Junior Consultant, Upazilla Health Complex, Keranigonj, Dhaka
Keywords: Bronchiolitis, Nebulized 3% hypertonic saline, 0.9% normal saline

Abstract

Background: Acute bronchiolitis is leading cause of hospitalization in infants below 2 years of age. Bronchiolitis being a viral disease, there is no effective treatment. 3% nebulized hypertonic saline and 0.9% nebulized normal saline are often used, although there is disagreement over their efficacy. The aim of this study was to evaluate the efficacy of 3% hypertonic saline in children with acute bronchiolitis in reducing clinical severity and length of hospital stay.

Methodology: A randomized control trial carried out in the Department of Pediatrics, Dhaka Medical College Hospital from January 2013 to December 2013.Ninty children from 1 month to 2 years of age hospitalized with clinical bronchiolitis were randomized to receive 3% nebulized hypertonic saline(Group-I) or 0.9% nebulized normal saline (Group-II). Nebulization was done 8 hourly until discharge. Outcome variable were clinical severity score, duration of oxygen therapy and length of hospital stay.

Results: Baseline clinical severity score and O2 saturation were in group-I 9.0±1.0 and 94.9±1.7 and in group- II 9.3±1.8 and 94.6±2.6 respectively (p>0.05). At 72 hours, the mean severity score for the group-I was 1.64±0.99 and that for the group-II was 3.0 ± 1.48 (95% CI -2.17 to - 0.53, p=0.002). The cases of group-I required a shorter duration of oxygen therapy compared to those of group-II (15.0±6.0 hours vs 26.4±5.37 hours, 95% CI -20.35 to -2.44, p<0.05). Forty two (93.3%) of the group-I children recovered by the end of72 hours and discharged whereas 26 (57.8%) of the group-II children recovered during the same period (p<0.05). Length of hospital stay was shorter in group-I compared to group-II (58.1±22.0 hours vs 74.7±27.2 hours, 95% CI -26.89 to- 6.17, p=0.002). None of the cases encountered any side-effects.

Conclusion: Nebulization with 3% hypertonic saline significantly reduced clinical severity, length of hospital stay and duration of oxygen therapy in case of acute bronchiolitis in comparison to 0.9% normal saline and was safe.

Bangladesh J Child Health 2018; VOL 42 (3) :130-137

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Author Biographies

Khandaker Tarequl Islam, Junior Consultant, Department of Pediatrics, Shaheed Suhrawardy Medical College Hospital, Dhaka

Department of Pediatrics

Abid Hossan Mollah, Professor, Department of pediatrics, BIRDEM, Dhaka

Department of pediatrics

Abdul Matin, Professor, Department of pediatrics, Dhaka Medical College, Dhaka

Department of Pediatrics

Mahmuda Begum, Junior Consultant, Upazilla Health Complex, Keranigonj, Dhaka

Department of Pediatrics

Published
2018-12-17
How to Cite
Islam, K., Mollah, A., Matin, A., & Begum, M. (2018). Comparative Efficacy of Nebulized 3% Hypertonic Saline versus 0.9% Normal Saline in Children with Acute Bronchiolitis. Bangladesh Journal of Child Health, 42(3), 130-137. https://doi.org/10.3329/bjch.v42i3.39264
Section
Original Articles