A Comparative Study to Assess the Effects of Nebulised 3% Hypertonic Saline, 0.9% Normal Saline and Salbutalmol in Management of Acute Bronchiolitis Among Indian Children

Abstract

To compare the effects of nebulised 3% hypertonic saline, 0.9% saline and salbutamol in patients of acute bronchiolitis. DESIGN: Randomised controlled trial. SETTING: tertiary care teaching hospital. MATERIAL AND METHODS: 100 Children with age 1 to 24 months admitted in hospital with clinical diagnosis of acute bronchiolitis for 2 consecutive years were included in the study. Participants were divided into 3 groups-3% hypertonic saline (HS), 0.9% normal saline and salbutalmol. 4 doses of nebulisation at an interval of 6 hours were given daily in each group till discharge. RESULTS: The mean age of the patients in the study population was 5.7 ± 3.4 months. Maximum number of the patients i.e. 65.7% belonged to the age group of 0-6 months. There was male preponderance in all 3 groups. Baseline Clinical Severity (CS) scores in 3%HS, 0.9% Normal Saline and Salbutamol groups were 5.9±1.5, 5.5±1.0 and 5.1±2.3 respectively (p=0.146). After treatment, the CS scores dropped to 1.0±1.1, 3.3±0.5 and 1.9±1.1 in 3%HS, 0.9% Normal Saline and Salbutamol groups respectively on the 3 rd day of treatment (p<0.01). Length of hospital stay in 3% HS, 0.9% Normal Saline and Salbutamol groups was 3.4±1.7, 4.9±1.4 and 3.7±1.9 days respectively, which was found to be statistically significant (p= 0.001). CONCLUSION: 3% Hypertonic Saline nebulization (without additional bronchodilators) is an effective and safe treatment in patients of acute bronchiolitis. It significantly reduces the CS scores and length of hospital stay as compared to 0.9% Normal Saline and Salbutamol nebulizations.

Comparative evaluation of nebulised 3% saline versus nebulised 0.9% saline in the treatment of acute bronchiolitis

“…Across various studies available, acute bronchiolitis is one of the major causes for hospital admissions of infants younger than 1 year of age, Table 1 shows the comparison of total number of cases studied with distribution of age, in the present study, the most common age group of children with acute bronchiolitis affected belongs to 2 months to 6 months. Similar observations were observed by Gaurav malik et al 7 This could be due to the fact that young infants have smaller airways and RSV infection is more common in that age group. Table 4 shows improvement in clinical severity score, the CSS improved more significantly in the 3% saline group (group B) from 7.12 to 2.05 compared to 0.9% saline group (group A).…”

“…Table 4 shows improvement in clinical severity score, the CSS improved more significantly in the 3% saline group (group B) from 7.12 to 2.05 compared to 0.9% saline group (group A). Similar observations were found in studies done by Gaurav et al, and Aayush et al 7,8 This is due to the fact that, more hypertonic a fluid better will be the mucociliary clearance. 3% saline breaks the ionic bonds within the mucus gel, thereby reducing the degree of cross linking and entanglements and lowering the viscosity and elasticity of the mucus secretion.…”

Comparative Study to Assess the Effectiveness of Nebulized 3% Hypertonic Saline and Nebulized Levosalbutamol in the Management of Bronchiolitis

“…The 2 × chromosomes in females which give more varieties in the immunogenic safeguard design might be attributed to low frequency of bronchiolitis in females when contrasted with males. In addition, in India, the guardians have progressively health care seeking mentality toward male child [15].…”

Evaluación De Solución Salina Hipertónica Y Salbutamol Nebulizado en El Tratamiento De Bronquiolitis en Niños Menores De 3 Años

“…Estudio pionero en BA de lactantes hospitalizados por Tal et al (2006) sobre la utilización de la SSH al 3% y epinefrina nebulizados en lactantes con BA en Tel Aviv (Israel), concluyeron que la SSH al 3% acorta la permanencia hospitalaria y el tratamiento tiene un excelente perfil de seguridad y efectividad. Hallazgo similar al encontrado en el presente estudio han sido reportados por (Al-Ansari et al, 2010;Malik et al, 2015;Grewal & Goldmann 2015;Zhang et al, 2015& Angoulvant et al, 2017.…”