EFFECTIVENESS OF NEBULIZED HYPERTONIC SALINE VERSUS NORMAL SALINE IN ACUTE VIRAL BRONCHIOLITIS MANAGEMENT
Main Article Content
Keywords
Bronchiolitis, Hypertonic Saline, Nebulization, Pediatric Respiratory Infections, Clinical Trial
Abstract
Introduction: Acute viral bronchiolitis is the leading cause of infant hospitalization, with limited therapeutic options beyond supportive care. Nebulized hypertonic saline may improve mucus clearance and reduce airway inflammation through osmotic mechanisms. This study evaluated the effectiveness of 3% hypertonic saline versus normal saline in bronchiolitis management.
Methods: A prospective observational study was conducted at Muzaffarnagar Medical College from June 2008 to December 2009. One hundred twenty infants aged 6 weeks to 24 months with acute viral bronchiolitis were randomized to receive nebulized 3% hypertonic saline (n=60) or 0.9% normal saline (n=60). Primary outcomes included clinical severity scores and hospital length of stay. Secondary outcomes assessed treatment failure rates, adverse events, and cost-effectiveness.
Results: Baseline characteristics were comparable between groups. Clinical severity scores improved significantly faster in the hypertonic saline group, with maximum benefit at 48 hours (mean difference -1.2 points, 95% CI: -1.7 to -0.7, p<0.001). Hospital length of stay was reduced by 22% (3.2±1.1 vs 4.1±1.6 days, p=0.001). Treatment failure rates were lower with hypertonic saline (3.3% vs 13.3%, p=0.047). Adverse events were mild and comparable between groups (20% vs 13.3%, p=0.32). Cost-effectiveness analysis showed savings of INR 1,275 per patient despite higher medication costs.
Conclusion: Nebulized 3% hypertonic saline significantly improves clinical outcomes in acute viral bronchiolitis, reducing severity scores, hospital length of stay, and treatment failures while maintaining acceptable safety and demonstrating economic advantages over normal saline therapy.
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Dr Pradeep Kumar Jain
Assistant Professor, Department of Paediatrics, Muzzaffarnagar Medical College, Muzzaffarnagar, Uttar Pradesh