Bronchiolitis is a common disorder in young children that often results in hospitalisation. Except for a possible effect of nebulised hypertonic saline (
sodium chloride), no evidence-based
therapy is available. This study investigated the efficacy of nebulised 3% and 6% hypertonic saline compared with 0.9% hypertonic saline in children hospitalised with
viral bronchiolitis. In this multicentre, double-blind, randomised, controlled trial, children hospitalised with acute
viral bronchiolitis were randomised to receive either nebulised 3%, 6% hypertonic saline or 0.9%
normal saline during their entire
hospital stay.
Salbutamol was added to counteract possible bronchial constriction. The primary endpoint was the length of
hospital stay. Secondary outcomes were need for supplemental
oxygen and
tube feeding. From the 292 children included in the study (median age 3.4 months), 247 completed the study. The median length of
hospital stay did not differ between the groups: 69 h (interquartile range 57), 70 h (IQR 69) and 53 h (IQR 52), for 3% (n=84) and 6% (n=83) hypertonic saline and 0.9% (n=80)
normal saline, respectively, (p=0.29). The need for supplemental
oxygen or
tube feeding did not differ significantly. Adverse effects were similar in the three groups. Nebulisation with hypertonic saline (3% or 6%
sodium chloride) although safe, did not reduce the
length of stay in hospital, duration of supplemental
oxygen or
tube feeding in children hospitalised with moderate-to-severe
viral bronchiolitis.