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(Chest. 2003;123:481-487.)
© 2003 American College of Chest Physicians

Nebulized 3% Hypertonic Saline Solution Treatment in Hospitalized Infants With Viral Bronchiolitis*

Avigdor Mandelberg, MD; Guy Tal, MD; Michaela Witzling, MD; Eli Someck, MD; Sion Houri, MD; Ami Balin, MD and Israel E. Priel, MD, FCCP

* From the Pediatric Pulmonary Unit (Drs. Mandelberg and Tal), the Department of Radiology (Dr. Witzling), the Unit of Pediatric Infectious Diseases (Dr. Someck), the Pediatric Critical Care (Dr. Houri), the Pediatric Department (Dr. Balin), and the Department of Pulmonary Medicine (Dr. Priel), The Edith Wolfson Medical Center, Holon, and The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Correspondence to: Avigdor Mandelberg, MD, Director, Pediatric Pulmonary Unit, The Department of Pulmonary Medicine and Pediatrics, The Edith Wolfson Medical Center, 62 Halochamim St, Holon 58100, Israel; e-mail: avigdorm{at}netvision.net.il

Objective: To determine the utility of inhaled hypertonic saline solution to treat infants hospitalized with viral bronchiolitis.

Design: Randomized, double-blind, controlled trial. Fifty-two hospitalized infants (mean ± SD age, 2.9 ± 2.1 months) with viral bronchiolitis received either inhalation of epinephrine, 1.5 mg, in 4 mL of 0.9% saline solution (group 1; n = 25) or inhalation of epinephrine, 1.5 mg, in 4 mL of 3% saline solution (group 2; n = 27). This therapy was repeated three times every hospitalization day until discharge.

Results: The percentage improvement in the clinical severity scores after inhalation therapy was not significant in group 1 on the first, second, and third days after hospital admission (3.5%, 2%, and 4%, respectively). In group 2, significant improvement was observed on these days (7.3%, 8.9%, and 10%, respectively; p < 0.001). Also, the improvement in clinical severity scores differed significantly on each of these days between the two groups. Using 3% saline solution decreased the hospitalization stay by 25%: from 4 ± 1.9 days in group 1 to 3 ± 1.2 days in group 2 (p < 0.05).

Conclusions: We conclude that in nonasthmatic, nonseverely ill infants hospitalized with viral bronchiolitis, aerosolized 3% saline solution/1.5 mg epinephrine decreases symptoms and length of hospitalization as compared to 0.9% saline solution/1.5 mg epinephrine.

Key Words: ß2-agonist • epinephrine • hypertonic saline solution • respiratory syncytial virus • viral bronchiolitis




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