COMPARISON OF 3% HYPERTONIC SALINE VERSUS NORMAL SALINE NEBULIZATION IN CHILDREN WITH ACUTE BRONCHIOLITIS

Abstract

Background: Acute bronchiolitis is a common lower respiratory tract infection in infants and young children, leading to significant morbidity and hospitalization. Effective management focuses on supportive care, but the optimal nebulization therapy remains debated. Hypertonic saline has been proposed to enhance mucociliary clearance and reduce airway edema, potentially improving clinical outcomes. This study compares the efficacy of nebulized 3% hypertonic saline versus normal saline in reducing clinical severity and hospital stay duration in children diagnosed with acute bronchiolitis.

Objective: To compare the effectiveness of 3% hypertonic saline versus normal saline nebulization in children with acute bronchiolitis.

Methods: This quasi-experimental study was conducted at the Pediatric Department, Combined Military Hospital, Lahore, from February to July 2022. Patients aged 3 months to 2 years diagnosed with acute bronchiolitis were included. Using a non-probability consecutive sampling technique, 74 patients were equally divided into two groups: Group HS received 3% hypertonic saline, and Group NS received 0.9% normal saline as a diluent for nebulization. Clinical severity score (CSS) at 0, 24, and 48 hours, along with the length of hospital stay (LOHS), were recorded and analyzed using SPSS version 23.

Results: The mean age was 8.19 ± 2.47 months in Group HS and 7.19 ± 2.62 months in Group NS. Gender distribution included 23 (62.16%) males and 14 (37.83%) females in Group HS, compared to 21 (56.75%) males and 16 (43.24%) females in Group NS. The mean CSS was significantly lower in Group HS at 24 hours (2 ± 0.57 vs. 2.3 ± 0.463, p = 0.023) and 48 hours (1.27 ± 0.65 vs. 1.62 ± 0.492, p = 0.018). The median LOHS was significantly reduced in Group HS (4 days, IQR: 4-5) compared to Group NS (5 days, IQR: 4-6) (p = 0.001).

Conclusion: Nebulized 3% hypertonic saline demonstrated superior efficacy in reducing clinical severity and hospital stay duration compared to normal saline in children with acute bronchiolitis. These findings support its inclusion as a standard treatment option to improve recovery outcomes.