Efficacy and Safety of 3% Hypertonic Saline Inhalation (24h vs 72h) to Treat Acute Bronchiolitis in Hospitalized Infants

Effects of Reduction of the Length of Treatment by Nebulized 3% Hypertonic Saline From 72 to 24 Hours on Clinical Remission, in Children Younger Than 12 Month Hospitalized for Acute Bronchiolitis. BRONDUSAL

Efficacy/Safety of 3% hypertonic saline inhalation (24H vs 72H) to treat acute bronchiolitis in infants.

In acute bronchiolitis in infants, 3% hypertonic saline nebulizations proved to be efficient, reducing the hospitalization length and clinical severity scores. Among the questions remaining, treatment length is still being discussed in the literature. The trial hypothesis is that the efficiency of a 24 hours treatment by 3% hypertonic saline is not inferior to a 72 hours treatment, in acute bronchiolitis in infants. The primary objective of the study is to compare the efficiency of a 24 hours treatment by 3 % hypertonic saline, versus a 72 hours treatment maximum, on clinical remission, judged by the Wang score measured 72 hours after starting treatment, in children younger than 12 month hospitalized for acute bronchiolitis.

Inclusion Criteria:

• 1st or 2nd episode of acute bronchiolitis, defined by respiratory symptoms episode with initial rhinitis, then cough, then one of the following symptoms : wheezing, crackling, respiratory distress
• Winter epidemic period from November, the 15th, to March the 15th
• Age < 12 months
• Admission Wang score included between 4 and 8
• Infant hospitalized for gravity clinical criteria of severity
• Nebulized 3 % hypertonic saline treatment since less than 24 hours
• Infant with social security card coverage
• Free consent of at least one of the parental authority holder

Exclusion Criteria:

• Pulmonary, cardiac or neurologic chronic underlying disease
• Prematurity < 32 GW
• Asthma (3rd episode or more)
• Admission oxygen saturation level < 85 %, Wang score ≥ 9