Utilization of vibrating mesh nebulizer in the treatment of infants with acute bronchiolitis: A randomized, controlled trial

Abstract

Background: Bronchiolitis is a disease that is predominantly caused by the infection of peripheral airway due to respiratory syncytial virus (RSV). The occurrence is highly prevalent among childhood stage with seasonal outbreak peak during fall and spring. Treatment of bronchiolitis invariably involves lengthy hospitalization, which places significant socio-economic burden on family caregivers and healthcare system. Aerosolizing hypertonic saline using small-volume jet nebulizer (SVN) remains as one of the effective therapies to alleviate symptoms in infants with acute bronchiolitis. However, such approach not only restraints treatment to hospitalization and can irritate patients with loud noise. It is unclear whether an alternative aerosol therapy that offers similar efficacy yet enhances portability, convenience and quiet operation is available. Materials and Methods: Herein we showed that a vibrating mesh nebulizer (VMN) offered quiet delivery and undisturbed nebulization yet harnessed similar improvement in clinical symptoms in contrast with SVN when treating hospitalized infants with acute bronchiolitis. Results: A total of 64 hospitalized infants (<12 months of age) with acute bronchiolitis were enrolled. Subjects were randomly assigned to SVN (n=32) and VMN (n=32) groups and had received the same aerosol treatment protocol during hospitalization. Besides respiratory rate, the initial overall severity score; hospital stay duration; and intravascular-line day for both groups (SVN vs VMN) were similar. The data were 4.30±1.44 vs 4.92±1.3; 3.97±1.88 vs 3.94±1.66 days; 2.31±1.47 vs 2.16±1.46 days correspondingly. However, a higher satisfaction score (4.8/5) was shown in a corresponding questionnaire indicating user preference in VMN due to enhanced portability, ease of clean and operation, and less-noise. These advantages could potentially facilitate bronchiolitis treatment and follow-up maintenance at home. Conclusion: In sum, the treatment outcome for infants with acute bronchiolitis was equivalent between SVN and VMN. Easy portability and simple operation features of VMN may present a much favored therapeutic option for home care users.