Efficacy and safety of nebulized hypertonic saline with or without epinephrine in management of acute bronchiolitis

Abstract

Bronchiolitis is an acute viral disease of the lower respiratory tract in children under two years of age, with a peak onset rate between 2-10 months of age. Objective: To evaluate the efficacy and safety of nebulized hypertonic saline with or without epinephrine in the management of acute bronchiolitis. Materials and methods: Longitudinal quasi-experimental study in infants admitted to the National Hospital Mario Catarino Rivas, with mild acute bronchiolitis.
Twenty-six cases were analyzed, randomized, 12 received nebulizations with 3% hypertonic saline solution (SSH + E) plus 1 ml of epinephrine and 14 received 3 ml of 3% hypertonic solution (HSS), administered every 4 hours, and Analysis of the Wood Downes- Ferres Score (SWD), oxygen saturation and complications after nebulizations were performed every 6 hours, for a period of 24 hours. The study was approved by an ethics committee. Results: Hospital stay was significantly reduced in the SSH group compared to the SSH + E group (1.79 ± 0.80 days: 2.50 ± 0.79 days, P = 0.032). The clinical score decreased in both groups, but there was no
statistically significant difference (p = 0.187 vs p = 0.074, upon arrival and after 24 hours). The complications found were statistically significant for the SSH + E group, after the first 3 nebulizations P = 0.007 and at 12 hours P = 0.019.
Conclusion: Nebulizations with SSH and with SSH + E are equally effective, however, SSH demonstrated greater safety and significantly shortened the hospital stay of hospitalized infants with mild acute bronchiolitis.