Nebulized 3% Hypertonic Saline in the Treatment of Acute Bronchiolitis

A Randomized Trial of Nebulized 3% Hypertonic Saline in the Treatment of Acute Bronchiolitis in The Emergency Department

This is a randomized, double-blind, controlled trial in the Pediatric Emergency Department. The primary objective is to determine whether nebulized 3% hypertonic saline is more effective than nebulized 0.9% saline in the treatment of bronchiolitis in the emergency department.

Inclusion Criteria:

• Children 2-12 months of age presenting to Emergency Department
• Patients with a diagnosis of bronchiolitis defined as the first episode of wheezing and/or crackles in a child younger than 12 months who has physical findings of a viral respiratory infection and has no other explanation for the wheezing and/or crackles
• Patients with an RDAI score ≥ 6 as measured by a trained respiratory therapist

Exclusion Criteria:

• Previous history of wheezing
• Known heart or lung disease
• Premature birth defined as birth before 37 weeks gestation
• Immunosuppression or immunodeficiency
• Treatment with corticosteroids in the previous 48 hours
• Critically ill children - progressive respiratory failure requiring higher level of care, vital signs instability/need for emergency interventions to prevent clinical deterioration
• Oxygen saturation <85% on room air at the time of recruitment