COMPARISON OF THE AVERAGE LENGTH OF HOSPITALIZATION BETWEEN TREATING BRONCHIOLITIS WITH SALBUTAMOL AND 3% HYPERTONIC SALINE IN CHILDREN.

Main Article Content

Ajet Kumar
Adnan Shaheen
Sonia Saleem
Fozia Baloch
Aizaz Ali Khan
Komal Sattar

Keywords

Hypertonic saline, salbutamol, nebulization, children, bronchiolitis

Abstract

Background: Bronchiolitis is a frequent respiratory illness in children. The virus can produce symptoms ranging from mild respiratory irritation to more serious pneumonia if it affects the lower respiratory tract. Bronchiolitis can arise for a variety of viruses, the most frequent one being the respiratory syncytial virus (RSV). Because of how severe the symptoms are, neonates are often more likely to contract the sickness. The patient's natural response to the reduced lung flexibility is to breathe more quickly, which leads to the classic symptoms of trapped air, increased mucus production, lung collapse, trouble breathing, and decreased airflow.


Objective: To compare the average length of hospitalization between treating bronchiolitis in children in our local population with salbutamol and 3% hypertonic saline.


Study design: a randomized control trial


Place and Duration This study was conducted in Al-Aleem Medical College, Ghulab Devi Teaching Hospital Lahore from October 2022 to October 2023.


Methodology: Children with a "respiratory distress assessment index" (RDAI) score between 4 and 15 who had a persistent dry cough and audible breathing sounds (wheezing) were included in the study. The children ranged in age from 1 month to 2 years. Demographic baselines were documented. A coin toss was used for randomization: Group A received heads for 3% hypertonic saline, while Group B received tails for salbutamol.


Results: A total of eighty participants were chosen to be included in this study. The children were split into two equal groups of forty in each. The age range of the children was one month to two years old. In Group A, the average age was 14.2 months and the average weight was 8.24 kg. In Group B, the average age was 15.7 months and the average weight was 8.6 kg. Group A mean hospital stay was 3.5 days, whereas group B mean hospital stay was 4.2 days.


Conclusion: Hospital stay duration and clinical severity scores (CS) are considerably decreased by HS as compared to salbutamol nebulization.

Abstract 85 | Pdf Downloads 36

References

1. Sharma BS, Gupta MK, Rafik SP. Hypertonic (3%) saline vs 0.9% saline nebulization for acute viral bronchiolitis: a randomized controlled trial. Indian pediatrics. 2013 Aug;50:743-7.
2. Pandit P, Hoque MA, Pandit H, Dhar SK, Mondal D, Ahmad F. Efficacy of Nebulized Hypertonic Saline (3%) Versus Normal Saline and Salbutamol in Treating Acute Bronchiolitis in A Tertiary Hospital: A Randomized Controlled Trial. Mymensingh Medical Journal: MMJ. 2022 Apr 1;31(2):295-303.
3. Hossain RM, Shams S, Kader A, Pervez M, Bhuiyan MF, Hasan MM, Mollah MA. Efficacy of nebulized hypertonic saline versus normal saline and salbutamol in treating acute bronchiolitis in a tertiary hospital: a randomized control trial. International Journal of Contemporary Pediatrics. 2022 Jun;9(6):1.
4. Wu S, Baker C, Lang ME, Schrager SM, Liley FF, Papa C, Mira V, Balkian A, Mason WH. Nebulized hypertonic saline for bronchiolitis: a randomized clinical trial. JAMA pediatrics. 2014 Jul 1;168(7):657-63.
5. Malik G, Singh A, Singh K, Pannu MS, Singh P, Banga S, Jain R. A comparative study to assess the effects of nebulised 3% hypertonic saline, 0.9% normal saline and salbutamol in management of acute bronchiolitis among Indian children. Journal of Evolution of Medical and Dental Sciences. 2015 Mar 12;4(21):3662-8.
6. Florin TA, Shaw KN, Kittick M, Yakscoe S, Zorc JJ. Nebulized hypertonic saline for bronchiolitis in the emergency department: a randomized clinical trial. JAMA pediatrics. 2014 Jul 1;168(7):664-70.
7. Jaquet-Pilloud R, Verga ME, Russo M, Gehri M, Pauchard JY. Nebulised hypertonic saline in moderate-to-severe bronchiolitis: a randomised clinical trial. Archives of disease in childhood. 2020 Mar 1;105(3):236-40.
8. Jacobs JD, Foster M, Wan J, Pershad J. 7% Hypertonic saline in acute bronchiolitis: a randomized controlled trial. Pediatrics. 2014 Jan 1;133(1):e8-13.
9. Grewal S, Ali S, McConnell DW, Vandermeer B, Klassen TP. A randomized trial of nebulized 3% hypertonic saline with epinephrine in the treatment of acute bronchiolitis in the emergency department. Archives of pediatrics & adolescent medicine. 2009 Nov 2;163(11):1007-12.
10. Yadav KK. 3% Hypertonic saline vs normal saline nebulization in children with acute bronchiolitis. Critical appraisal of an article “Hypertonic (3%) saline vs 0.9% saline nebulization for acute viral bronchiolitis: A randomized controlled trial. Sharma BS, Gupta MK, Rafik SP, Indian Pediatr. 2013 Aug; 50 (8): 743–47”. Clinical Epidemiology and Global Health. 2014 Dec 1;2(3):141-2.
11. 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.
12. Mandelberg A, Tal G, Witzling M, Someck E, Houri S, Balin A, et al. Nebulized 3% hypertonic saline solution treatment in hospitalized infants with viral bronchiolitis. Chest. 2003;123:481–7.
13. Tal G, Cesar K, Oron A, Houri S, Ballin A, Mandelberg A. Hypertonic saline/epinephrine treatment in hospitalized infants with viral bronchiolitis reduces hospitalization stay: 2 years experience. Isr Med Assoc J. 2006;8:169–73.
14. Kuzik BA, Al-Qadhi SA, Kent S, Flavin MP, Hopman W, Hotte S, et al. Nebulized hypertonic saline in the treatment of viral bronchiolitis in infants. J Pediatr. 2007;151:266–70. 270.e1.
15. Supino MC, Buonsenso D, Scateni S, Scialanga B, Mesturino MA, Bock C, et al. Point-ofcare lung ultrasound in infants with bronchiolitis in the pediatric emergency department: a prospective study. Eur J Pediatr. 2019;178(5):623-32.
16. Lodeserto FJ, Lettich TM, Rezaie SR. High-flow nasal cannula: mechanisms of action and adult and pediatric indications. Cureus. 2018;10(11):e3639.
17. Stobbelaar K, Kool M, de Kruijf D, Van Hoorenbeeck K, Jorens P, De Dooy J, et al. Nebulised hypertonic saline in children with bronchiolitis admitted to the paediatric intensive care unit: a retrospective study. J Paediatr Child Health. 2019;55(9):1125-32.
18. Gold J, Hametz P, Sen AI, Maykowski P, Leone N, Lee DS, et al. Provider knowledge, attitudes, and practices regarding bronchiolitis and pneumonia guidelines. Hosp Pediatr. 2019;9(2):87-91.
19. Picone S, Fabiano A, Roma D, Di Palma F, Paolillo P. Re-comparing of three different epidemic seasons of bronchiolitis: different prophylaxis approaches. Ital J Pediatr. 2018;44(1):148.
20. 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.

Most read articles by the same author(s)