Nebulized 3% saline effective for viral bronchiolitis

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Nebulized 3% saline effective for viral bronchiolitis

J Fam Pract. 2003 May;52(5):349-364

By

Andrea D. Tribastone, MD

BACKGROUND: Viral bronchiolitis is a common cause of illness in children aged <24 months. Studies have found no benefit in treatment with steroids or ribavirin. A Cochrane review of bronchodilators for the treatment of bronchiolitis showed only modest short-term improvement in clinical scores, which must be weighed against side effects. Hypertonic saline solution, by absorbing water from the submucosa, can theoretically reverse some of the bronchiolar edema.
POPULATION STUDIED: The authors studied 70 infants under the age of 24 months who presented to an ambulatory pediatric clinic with a clinical presentation of mild-to-moderate bronchiolitis. Infants were excluded if they had any cardiac or chronic respiratory illness, previous wheezing episode, oxygen saturation <96% on room air, or need for hospitalization.
STUDY DESIGN AND VALIDITY: In this double-blinded, randomized study, infants were assigned to either a control or treatment group. The control group received inhalations of 0.5 mL (5 mg) terbutaline in 2 mL of 0.9% saline solution as a wet nebulized aerosol, while the treatment group received inhalations of the same dose of terbutaline in 2 mL of 3% saline solution. Infants in both groups were given 3 treatments per day (every 8 hours) for 5 days.
OUTCOMES MEASURED: The examiners compared the change in a 12-point clinical severity score over a 5-day course of treatment. The rate of hospitalization in each group was also measured.
RESULTS: The clinical severity of each group was similar at the beginning of the study (6.4 for the control group and 6.6 for the treatment group). After day 1, the clinical severity score before inhalation therapy was significantly better (P<.005) in the treatment group than the control group (day 2, 3.9 vs 5.2; day 3, 2.1 vs 4.8; day 4, 1.1 vs 3.8; day 5, 0.9 vs 2.9).

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Nebulized 3% saline effective for viral bronchiolitis

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