Nebulized 5% or 3% hypertonic or 0.9% saline for treating acute bronchiolitis in infants.

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  • Additional Information
    • Source:
      Publisher: Mosby Country of Publication: United States NLM ID: 0375410 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6833 (Electronic) Linking ISSN: 00223476 NLM ISO Abbreviation: J Pediatr Subsets: MEDLINE
    • Publication Information:
      Original Publication: St. Louis, MO : Mosby
    • Subject Terms:
      Bronchiolitis/*drug therapy ; Bronchiolitis/*epidemiology ; Bronchodilator Agents/*therapeutic use ; Saline Solution, Hypertonic/*therapeutic use; Acute Disease ; Administration, Inhalation ; Ambulatory Care ; Bronchiolitis/virology ; Bronchodilator Agents/administration & dosage ; Double-Blind Method ; Female ; Humans ; Infant ; Male ; Nebulizers and Vaporizers ; Respiratory Syncytial Virus Infections/complications ; Respiratory Syncytial Virus Infections/drug therapy ; Respiratory Syncytial Viruses/isolation & purification ; Saline Solution, Hypertonic/administration & dosage
    • Abstract:
      Objective: To compare the efficacy and safety of 5%, 3%, and 0.9% saline solution for treating acute bronchiolitis in the prehospital setting.
      Study Design: This was a double-blind trial including consecutive infants aged <18 months treated in an urban urgent care setting. A total of 165 patients were randomized to receive nebulized 5%, 3%, or 0.9% (normal) saline with epinephrine every 4 hours. The primary efficacy outcome was bronchiolitis severity score improvement at 48 hours (chi2 analysis). Scores and oxygen saturation immediately before and after each treatment were recorded to assess safety.
      Results: A total of 187 previously healthy infants (median age, 3.1 months) diagnosed with bronchiolitis were enrolled. Positivity for respiratory syncytial virus was similar in the 3 treatment groups (mean, 56%). At 48 hours, the mean severity score for the 5% saline group was 3.69+/-1.09, and that for the 0.9% saline group was 4.12+/-1.11 (P=.04; difference, 0.43, 95% confidence interval for the difference, 0.02-0.88). The mean severity score for the 3% saline group was intermediate at 4.00+/-1.22. Revisit rates after discharge were similar in the 3 treatment groups. No adverse reactions or other safety concerns were identified.
      Conclusions: Nebulization with 5% hypertonic saline is safe, can be widely generalizable, and may be superior to current treatment for early outpatient treatment of bronchiolitis.
      (Copyright (c) 2010 Mosby, Inc. All rights reserved.)
    • Comments:
      Comment in: Evid Based Med. 2011 Jun;16(3):82-3. (PMID: 21278203)
      Comment in: J Pediatr. 2011 Mar;158(3):515. (PMID: 21316528)
      Comment in: J Pediatr. 2011 Aug;159(2):353; author reply 354. (PMID: 21592507)
    • Molecular Sequence:
      ClinicalTrials.gov NCT01016249
    • Accession Number:
      0 (Bronchodilator Agents)
      0 (Saline Solution, Hypertonic)
    • Publication Date:
      Date Created: 20100722 Date Completed: 20101008 Latest Revision: 20110831
    • Publication Date:
      20240829
    • Accession Number:
      10.1016/j.jpeds.2010.04.074
    • Accession Number:
      20646715