The Efficacy of Nebulized 3% Hypertonic Saline for Acute Bronchiolitis in Infants: A Randomized Controlled Trial

Abstract

Background: In infants with acute bronchiolitis, the primary pathological characteristics involve airway edema and mucus plugging, leading to obstruction. Nebulized 3% hypertonic saline has been proposed as a potential treatment to alleviate these pathological changes and improve airway patency. However, current evidence supporting its efficacy remains inconclusive and requires further investigation. Objectives: This study aims to evaluate the effectiveness of nebulized 3% hypertonic saline in Vietnamese infants with acute bronchiolitis, thereby contributing to evidence supporting one of the potential treatment options for this condition. Methods: A randomized control trial was performed on 140 infants with acute bronchiolitis admitted to the Respiratory Department of Can Tho Children’s Hospital from August 2022 to May 2024. Participants were randomly assigned to either the intervention group (n = 70), receiving nebulized 3% hypertonic saline in addition to standard care, or the control group (n = 70), receiving only standard care. Clinical outcomes were assessed using the clinical severity score (CSS) and respiratory distress assessment instrument (RDAI) over a three-day treatment period. Length of hospital stay (LOS) was also recorded. Results: The intervention group demonstrated significant improvements in CSS [median: 1 (0 - 3)] and The RDAI [median: 0 (0 - 3)] after three days of treatment compared to the control group [CSS median: 2 (0 - 7), RDAI median: 4 (0 - 8); P < 0.001]. Additionally, the hypertonic saline group had a significantly shorter median LOS of 5 days (range: 3 - 10) compared to 7 days (range: 3 - 15) in the control group (P < 0.001). No adverse effects were observed in the treatment group. Conclusions: Nebulized 3% hypertonic saline significantly improves clinical severity and reduces hospital stay in infants with acute bronchiolitis, making it a safe and effective treatment option.