Dr. Khalid Al-Ansari, and colleagues with Hamad Medical Corporation in Doha note in an online issue of The Journal of Pediatrics that inhaled 3% saline administered with epinephrine by nebulization has been shown to improve symptoms in pediatric bronchiolitis more effectively than normal (0.9%) saline. They reasoned that 5% saline might produce further improvement.
The team compared nebulized 5%, 3%, or 0.9% saline with epinephrine administered every 4 hours in 171 infants with acute viral bronchiolitis treated in a pediatric emergency center. Initially, the mean severity scores in the three treatment groups were not statistically different at 5.65, 6.16 and 5.77, respectively.
At 48 hours, the mean severity score had dropped to 3.69 in the 5% saline groups compared with 4.11 in the normal saline arm (p=0.04). It was intermediate in the 3% group at 4.00.
Scores at other time points showed a consistent trend favoring 5% saline.
As for safety, “No patient was withdrawn from the study because of apnea, cyanosis, or decreased oxygen saturation” the investigators report. “No patient required hospital or ICU admission during their study visit for bronchiolitis.”
Dr. Al-Ansari and colleagues conclude that nebulization with 5% hypertonic saline “is safe and may be superior to current treatment for early infirmary outpatient treatment of bronchiolitis.” They say a clinical trial with a larger sample size is in the planning stage.
J Pediatr 2010;