Comparison of the effectiveneses of nebulised hypertonic saline alone and in combination with short effected beta agonists in the treatment of acute viral bronchiolitis

Objective: The objective of this study was to investigate the effectivenesses of nebulized low volume 3% saline, high volume 3% saline, salbutamol and low volume 3% saline combination, salbutamol and high volume 3% saline combination and salbutamol alone. Material and Methods: We enrolled 150 children (mean age 11,3 ± 5,5 months, range 2–24 months, 62,7% male) with a first or second episode of wheezing diagnosed as moderate bronchiolitis in emergency department or outpatient clinic. Patients were randomized in a double-blind fashion to receive 3 ml dose of 3% saline (group 1; n=30) or 6 ml dose of 3% saline (group 2; n=30) or 3 ml dose of 3% saline plus salbutamol (group 3; n=30) or 6 ml dose of 3% saline plus salbutamol (group 4; n=30) or salbutamol alone (group 5; n=30) at 0 and 60 min. Thus, all treatment modalities except group 5 included high amount of NaCl (180-360 mg). Clinical score, oxygen saturation and heart rate were assessed at 0, 60, 120, and 180min. After discharge, patients were reassessed by telephone contact at 24 hr and 7 days. Results: The baseline characteristics were similar in all groups (P>0.05). All treatment modalities are found effective for the treatment of acute bronchiolitis. Heart rates were higher at 60 and 180 minutes in the groups receiving salbutamol alone and salbutamol plus 3% saline combinations than non-salbutamol groups. Roughly, there were no significant differences between the outcome variables of the groups, except heart rates (P>0.05). No adverse effects attributable to nebulized therapy were seen. Conclusion: All treatment modalities used in this study, including a total of 6 or 12 ml 3% saline inhalation and salbutamol alone at 60-min interval showed clinically significant and swift improvement in moderately affected ambulatory infants with acute bronchiolitis.