Normal Saline vs. Hypertonic Saline Nebulization for Acute Bronchiolitis: A Randomized Clinical Trial

Background We aimed to compare the efficacy of nebulized hypertonic (3%, 5% and 7%) saline with normal saline in hospitalized infants with acute bronchiolitis. Materials and Methods In this triple-blinded randomized clinical trial, 120 children with moderate to severe bronchiolitis randomly assigned into four groups to receive nebulized normal saline (group A), saline 3% (group B), saline 5% (group C), and saline 7% (group D). The length of hospital stay (LOS) as primary outcome and the use of oxygen, temperature, oxygen saturation (SPO2), pulse rate (PR), respiratory rate (RR), and bronchiolitis severity score were measured in the beginning of the study and during hospitalization. Results The mean age of patients was 5 + 0.423 months and 79 of them (65%) were male. The length of hospital stay (LOS), and use of oxygen supplementation was not different between group A and B (P=0.36), but significantly lower than group C and D (P<0.001). Vital signs, improvement in severity score and oxygen saturation were similar between groups. Conclusion Our study demonstrated that nebulization with 3% hypertonic saline and 0.9% saline can significantly reduce hospitalization rate compared nebulization with 5% and 7% hypertonic saline.