Comparison of 3% saline versus normal saline as a diluent for nebulization in hospitalized children with acute bronchiolitis: A randomized clinical trial

Context: Bronchiolitis, the most common lower respiratory tract infection among infants and young children, is managed with a few clinically beneficial interventions. Hypertonic saline (HS) nebulization is suggested in the treatment of bronchiolitis, resulting in clinical improvement. Aim: The aim of the study was to compare the efficacy 3% HS versus 0.9% normal saline (NS) as nebulization diluent in children between 3 months and 2 years with acute bronchiolitis. Materials and Methods: In this prospective randomized controlled study, 158 admitted children between 3 months and 2 years with acute bronchiolitis were assigned into two groups – 3% HS and NS. Outcome variables were improvement in clinical severity (CS) score and length of hospital stay (LOS). Descriptive statistics such as mean, median, standard deviation, and percentages were used. Chi-square and t-tests were used to determine associations. Data analysis was performed using SPSS IBM version 21. Results: Baseline CS scores were similar – 3.98 ± 1.20 and 3.75 ± 1.06 for HS and NS groups (P = 0.209), respectively, but from the 2nd day of treatment, it decreased to 2.21 ± 1.10 for HS and 3.05 ± 1.17 for NS group (P ≤ 0.001), further reducing to 1.46 ± 0.63 for HS group and 2.01 ± 0.99 for NS group (P ≤ 0.001). Length of stay was also reduced: 4.98 ± 1.35 for the HS group compared to 5.84 ± 1.18 for the NS group (P ≤ 0.001). Conclusion: Using 3% HS instead of NS as a diluent for nebulization decreases clinical symptoms acute bronchiolitis besides the length of hospital stay.