Efficacy of Nebulisation with 3 % (Hypertonic Saline) vs 0.9 % (Normal Saline) in the Treatment of First Episode of Wheeze in Children <18 Months- A Randomized Controlled Study.

Corresponding Author:
Dr. Rekha Sasidharan Nair,
Assistant Professor,
Department of Paediatrics,
Sree Gokulam Medical College and
Research Foundation, Kerala, India.
E-mail: reksnair77@gmail.com

ABSTRACT

BACKGROUND

Nebulised hypertonic saline for bronchiolitis is becoming a popular modality in the treatment of bronchiolitis. Definite guidelines in the management of bronchiolitis are still lacking. We wanted to compare the efficacy of nebulized 3% saline versus nebulized normal saline (0.9%) when used with levosalbutamol in infants <18 months, hospitalized with first episode of wheeze.

METHODS

This is a randomized controlled study conducted in a tertiary care setting, over a period of one year, among infants <18 months of age, who presented with 1st episode of wheezing, meeting the clinical diagnostic criteria for bronchiolitis. The Respiratory Distress Assessment Instrument (RDAI) score was calculated at admission and regular intervals. The duration from enrollment to readiness for discharge was recorded. Infants were considered as fit to discharge when the RDAI becomes zero.

RESULTS

In this group of 72 infants, the pre inhalation mean RDAI score was 3.8 as compared to post inhalation score of 3.1 in the normal saline group and 4.2 and 3.1 respectively in the hypertonic saline group. Though both the groups showed a statistically significant clinical improvement (p=0.000) in terms of RDAI scoring at the end of one hour, the improvement was substantially more in case of hypertonic saline nebulisation (mean difference 1.1) compared to normal saline (mean difference 0.7). Hence patients receiving hypertonic saline nebulization had better improvement in terms of RDAI scoring at the end of I hr.

CONCLUSIONS

Hypertonic saline nebulisation is a better alternative to normal saline for nebulisation in children <18 months of age with first episode of wheeze.

KEY WORDS

Bronchiolitis, Hypertonic Saline, Nebulisation, RDAI Scoring