EFFICACY OF 0.9% SALINE OVER 3% SALINE NEBULISATION IN HOSPITALISED CHILDREN WITH ACUTE BRONCHIOLITIS: A RANDOMISED CONTROLLED TRIAL

Dr. Yazhini*, Dr. Thumjaa Annamalai and Dr. Jakanattane

ABSTRACT

Introduction: Respiratory tract infections are one of the most common causes of illness among children and are responsible for nearly one-sixth of all deaths in children. The term LRTI is used to cover all those infections of respiratory tract that occur below the level of the larynx and include bronchiolitis, bronchitis, tracheitis, and bronchopneumonia. Acute bronchiolitis is one of the most common lower respiratory tract infections in infants and young children and generally has an underlying viral etiology. RSV is recognized as the most common viral pathogen. Objective of our study is to compare efficacy among 0.9% saline nebulization and 3% saline by monitoring the length of hospital stay and recording clinical severity score. Methods: Over the period of two years, Infants and young children aged (1-24 months) with diagnosis of acute bronchiolitis in Department of Paediatrics, after obtaining informed and written consent from the parents detailed history, clinical assessment and clinical severity scoring (Wang et al) was done. “All eligible infants and young children were randomized in consecutive manner and were divided into 2 subgroups and assigned to receive nebulization either with 4ml of 0.9% saline or 3% saline through conventional nebulizer with tight-fitting mask connected to a source pressurized oxygen set to a flow rate of 7L/min. Nebulization was continued till the nebulization chamber was empty”. Hospitalized infants and young children were clinically assessed by clinical severity scoring (Wang et al)Error! Bookmark not defined. and length of hospital stay was noted. Discharge criteria included “orally feeding well, no need for oxygen supplementation and intravenous fluids, clinical severity score<3, absence of accessory muscle use or tachypnea and oxygen saturation >92% in room air”. Data so collected was fed into computer using MS-Excel 2013 software. The data was compared between the two study groups using IBM Statistical Package for Social Sciences (IBM Inc., 2012). Chi square test was used for categorical data, Independent samples „t‟-test was used for parametric data and Mann-Whitney U test was used for non-parametric data. Results: Out of the 110 children enrolled in the study, a total of 55 (50%) were allocated to Group 1 and were nebulized with 0.9% saline while remaining 55 (50%) were allocated to Group 2 and were nebulized with3% saline. Statistically, there was no significant difference between two groups in proportion of patients achieving clinical severity score <3 at different follow-up intervals (p>0.05). The median duration was 3 days in both the groups and there was no significant difference between two groups with respect to duration of hospital stay (p>0.05) Conclusions: On the basis of the findings of the present study it could be concluded that in patients presenting with mild to moderate severity of acute bronchiolitis both 0.9% as well as 3% saline nebulization were equally effective and use of 0.9% saline nebulization did not result in reduction of time taken for symptomatic recovery and duration of hospital stay.

Keywords: Acute bronchiolitis, 0.9% Nacl Nebulization, 3%Nacl nebulisation.