COMPARATIVE STUDY TO ASSESS THE EFFECTIVENESS OF NEBULIZED 3% HYPERTONIC SALINE AND NEBULIZED LEVOSALBUTAMOL IN THE MANAGEMENT OF BRONCHIOLITIS
Keywords:Bronchiolitis, 3 hypertonic saline, Levosalbutamol, Modified respiratory distress assessment instrument, Nebulization
Objective: The objective of the study was to compare the effects of nebulized 3% hypertonic saline and nebulized levosalbutamol in the management of bronchiolitis.
Methods: Seventy children of age 1–24 months admitted into the hospital with the diagnosis of bronchiolitis. Participants were divided into two groups of 35 each. Group A was given nebulized 3% hypertonic saline and Group B was given nebulized levosalbutamol. Modified respiratory distress assessment instrument (RDAI) is used at admission, at 48 h after admission, and at the time of discharge to identify the reduction in scores between two groups.
Results: The mean age of patients in the study population was 10.1±6.4 months. The mean birth weight of patients in Group A and Group B was 3.00±0.61 and 3.12±0.75. The percentage of male patients was 57.1% and the percentage of female patients was 42.8%. The modified RDAI score in Group A and Group B at admission, 48 h of admission, and at the time of discharge was 4.34±0.87, 2.4±1.03, and 0.67±0.05 (p=0.04) and 4.11±0.58, 3.60±1.00, and 2.51±0.96 (p=0.12). The hospital stay was observed to be lowered in Group A (3.77±0.88) compared to Group B (5.43±0.92; p=0.04).
Conclusion: From the findings of our study, we conclude that nebulized 3% hypertonic saline, as it acts by hindering the pathophysiologic mechanism of bronchiolitis, is more effective in reducing the clinical severity score and length of hospital stay. Further 3% hypertonic saline also have the additional benefit of decreasing the economic burden of disease as it is safe, inexpensive, reduces the inpatient hospital charges by reducing the length of stay.
Chaudhary K, Sinert R. Is nebulized hypertonic saline solution an effective treatment for bronchiolitis in infants? Ann Emerg Med 2010;55:120-2.
Handforth J, Friedland JS, Sharland M. Basic epidemiology and immunopathology of RSV in children. Paediatr Respir Rev 2000;1:210-4.
Epidemiology of Respiratory Syncytial Virus Infections; 2020. Available from: http://www.virology-online.com/viruses/rsv2.htm. [Last accessed on 2020 Jan 25].
Williams JV, Harris PA, Tollefson SJ, Halburnt-Rush LL, Pingsterhaus JM, Edwards KM et al. Human metapneumovirus and lower respiratory tract disease in otherwise healthy infants and children. N Engl J Med 2004;350:443-50.
Alexander KC, James DK, Davies HD. Respiratory syncytial virus bronchiolitis. J Natl Med Assoc 2005;97:1708-13.
Igor R, Tomaskovic L, Boschi-Pinto C, Campbell H. Global estimate of the incidence of clinical pneumonia among children under five years of age. Bull World Health Organ 2004;82:895-903.
Ralston SL, Lieberthal AS, Meissner HC, Alverson BK, Baley JE, Gadomski AM, et al. Clinical practice guideline: The diagnosis, management, and prevention of bronchiolitis. Pediatrics 2014;134:e1474-502.
Hasegawa K, Tsugawa Y, Brown DF, Mansbach JM, Camargo CA. Trends in bronchiolitis hospitalizations in the United States 2000-2009. Pediatrics 2013;132:28-36.
Dennis MM. Bronchiolitis. Arch Dis Child Educ Pract 2005;90:81-6.
Yorita KL, Holman RC, Sejvar JJ, Steiner CA, Schonberger LB. Infectious disease hospitalizations among infants in the United States. Pediatrics 2008;121:244-52.
Deshpande S, Northern V. The clinical and health economic burden of respiratory syncytial virus disease among children under 2 years of age in a defined geographical area. Arch Dis Child 2003;88:1065-9.
Sarrell EM, Tal G, Witzling M, Someck E, Houri S, Cohen HA, et al. Nebulized 3% hypertonic saline solution treatment in ambulatory children with viral bronchiolitis decreases symptoms. Chest 2002;122:2015-20.
Koker O, Ozdogan S, Kose G, Yildirmak Z. Comparison of the efficacies of normal saline versus hypertonic saline in the management of acute bronchiolitis. Int J Contemp Pediatr 2016;3:795-800.
Kuzik BA, Al Qadhi SA, Kent S, Flavin MP, Hopman W, Hotte SA, et al. Nebulized hypertonic saline in the treatment of viral bronchiolitis in infants. J Pediatr 2007;151:266-70.
Malik G, Singh A, Singh K, Pannu MS, Singh P, Banga S, et al. A comparative study to assess the effects of nebulised 3%, 0.9% normal saline and salbutamol in the management of acute bronchiolitis among indian children. J Evol Med Dent Sci 2015;4:3662-8.
Mandelberg A, Tal G, Witzling M, Somexk E, Houri S, Balin A, et al. Nebulized 3% hypertonic saline solution treatment in hospitalized infants with viral bronchiollitis. Chest 2003;123:481-7.
Zhang L, Mendoza-Sassi RA, Klassen TP, Wainwright C. Nebulized hypertonic saline for acute bronchiolitis: A systematic review. Pediatrics 2015;136:687-701.
Luo Z, Liu E, Luo J, Li S, Zeng F, Yang X, et al. Nebulized hypertonic saline/salbutamol solution treatment in hospitalized children with mild to moderate bronchiolitis. Pediatr Int 2010;52:199-202.
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