Nebulized 7% Hypertonic Saline for Bronchiolitis

Katherine Bakes, MD

In infants, 7% hypertonic saline with epinephrine did not decrease bronchiolitis severity scores or need for admission compared with normal saline plus epinephrine.

Investigators compared the efficacy of 3 mL inhaled 7% hypertonic saline versus 3 mL normal saline in a double-blind, randomized, controlled trial of infants and children ages 6 weeks to 18 months presenting to an emergency department (ED) with moderately severe bronchiolitis. All patients also received 0.5 mL nebulized racemic epinephrine. Admitted patients received their study medication every 6 hours until discharge.

During two bronchiolitis seasons, 52 infants (mean age, 6 months) received 7% hypertonic saline and 49 (mean age, 5.6 months) received normal saline. The two groups demonstrated similar improvement in bronchiolitis severity scores after the first treatment, at 4 hours (or time of ED disposition if earlier), and at 24 hours (for admitted patients). There were also no between-group differences in proportion of patients admitted, proportion discharged at 23 hours after admission, or inpatient length of stay.

Citation(s):

Jacobs JD et al. 7% Hypertonic saline in acute bronchiolitis: A randomized controlled trial. Pediatrics 2013 Dec 16.