Comparison of 3% Normal Saline Nebulization versus Steroid Nebulization in the Treatment of Bronchiolitis

Main Article Content

Muhammad Suleman
Faizan Sadiq
Muhammad Qasim Khan
Abdul Jabar
Arooj Khan
Nighat Musa

Abstract

Background: Bronchiolitis is a leading cause of hospitalization in infants. This study aimed to compare the efficacy of 3% normal saline nebulization with steroid nebulization in the treatment of bronchiolitis.


Methods: Conducted at the Department of Pediatrics, Mardan Medical Complex, Mardan from November 15, 2022, to March 15, 2023, this randomized controlled trial involved 60 infants aged 3 to 12 months diagnosed with bronchiolitis. They were equally randomized into two groups: Group-A received 3% normal saline nebulization, while Group-B was treated with steroid and salbutamol nebulization, administered three times daily. Efficacy assessments were made at 0, 12, 24, 48, and 72 hours using the respiratory distress assessment instrument. The primary outcome was defined as the number of patients discharged from the hospital within ≤ 72 hours after starting treatment. The chi-square test was used for statistical comparison, with p ≤0.05 considered significant.


Results: The mean±SD age in the study was 6.91±2.41 months, with a gender distribution of 55% male and 45% female. The study revealed that a significantly higher number of infants in Group-A were discharged from the hospital within ≤ 3 days compared to Group-B (90% vs 63.33%, p=0.01). Additionally, Group-A had a significantly shorter mean length of hospital stay (2.76±0.51 days) compared to Group-B (3.58±0.82 days, p=0.00).


Conclusion: Nebulization with 3% normal saline was found to be significantly more effective than steroid nebulization in reducing the severity of bronchiolitis and the duration of hospitalization in infants aged between 3-12 months.

Article Details

How to Cite
Suleman , M., Sadiq, F., Qasim Khan , M., Jabar , A., Khan, A., & Musa , N. (2023). Comparison of 3% Normal Saline Nebulization versus Steroid Nebulization in the Treatment of Bronchiolitis. Journal of Health and Rehabilitation Research, 3(2), 472–476. https://doi.org/10.61919/jhrr.v3i2.181
Section
Articles
Author Biographies

Muhammad Suleman , Mardan Medical Complex- Mardan

Postgraduate Resident, Department of Pediatrics

Faizan Sadiq, Mardan Medical Complex- Mardan

Postgraduate Resident, Department of Pediatrics

Muhammad Qasim Khan , Bacha Khan Medical College-Mardan

Associate Professor Paeds

Abdul Jabar , Mardan Medical Complex- Mardan

Post Graduate Trainee, Medical Officer

Arooj Khan, Khyber Teaching Hospital- Peshawar

Post Graduate Resident, Department of Pediatrics

Nighat Musa , Bacha Khan Medical College- Mardan

Assistant Professor Community Medicine Department

References

Polack FP, Stein RT, Custovic A. The syndrome we agreed to call bronchiolitis. J Infect Dis. 2019;220(2):184-186.

Jo YM, Kim J, Chang J. Vaccine containing G protein fragment and recombinant baculovirus expressing M2 protein induces protective immunity to respiratory syncytial virus. Clin Exp Vaccine Res. 2019;8(1):43-53.

Fretzayas A, Moustaki M. Etiology and clinical features of viral bronchiolitis in infancy. World J Pediatr. 2017;13:293-299.

Li Y, Wang X, Blau DM, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: A systematic analysis. Lancet. 2022;399:2047-2064.

Schlapbach LJ, Straney L, Gelbart B, et al. Burden of disease and change in practice in critically ill infants with bronchiolitis. Eur Respir J. 2017;49:1601648.

Panda S, Mohakud NK, Suar M, Kumar S. Etiology, seasonality, and clinical characteristics of respiratory viruses in children with respiratory tract infections in Eastern India (Bhubaneswar, Odisha). J Med Virol. 2017;89:553-558.

Heppe Montero M, Gil Prieto R, Walter S, Aleixandre Blanquer F, Gil De Miguel Á. Burden of severe bronchiolitis in children up to 2 years of age in Spain from 2012 to 2017. Hum Vaccin Immunother. 2022;18:1883379.

Skjerven HO, Megremis S, Papadopoulos NG, et al. Virus type and genomic load in acute bronchiolitis: Severity and treatment response with inhaled adrenaline. J Infect Dis. 2016;213:915-921.

National Institute for Health and Care Excellence. Bronchiolitis: Diagnosis and Management in Children (Clinical guideline). London, UK: National Institute for Health and Care Excellence; 2015.

Oz-Alcalay L, Ashkenazi S, Glatman-Freedman A, et al. Hospitalization for respiratory syncytial virus bronchiolitis in the palivizumab prophylaxis era: need for reconsideration of preventive timing and eligibility. Isr Med Assoc J. 2019;21(2):110-115.

Gold J, Hametz P, Sen AI, et al. Provider knowledge, attitudes, and practices regarding bronchiolitis and pneumonia guidelines. Hosp Pediatr. 2019;9(2):87-91.

Ahmad S, Shahzad S, Khan UN, et al. Efficacy of corticosteroids in acute bronchiolitis: short term outcomes. Rawal Med J. 2019;44(3): 509-512.

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.

Dhal SS, Sagar H. Managing bronchiolitis in pediatric patients: Current evidence. Indian J Respir Care. 2022;11:291-295.

Hossain RM, Shams S, Kader MA, et al. Efficacy of nebulized hypertonic saline versus normal saline and salbutamol in treating acute bronchiolitis in a tertiary hospital: a randomized control trial. Int J Contemp Pediatr. 2022;9:523-528.

Gupta HV, Gupta VV, Kaur G, et al. Effectiveness of 3% hypertonic saline nebulization in acute bronchiolitis among Indian children: A quasi-experimental study. Perspect Clin Res. 2016 Apr-Jun;7(2):88-93.

Stobbelaar K, Kool M, de Kruijf D, 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):1125-1132.

Majagaiya BS, Cheng HJ, Yin JN, et al. Outcome of treatment with nebulized 3% hypertonic saline solution in infants hospitalized with moderate bronchiolitis. Int J Pregn and Chi Birth. 2022;8(2):42-46.

Ali A, Naeem HMM, Rafique A, et al. Comparison of Hypertonic Saline vs Salbutamol in Normal Saline Nebulization in Children with Bronchiolitis. Pak J Med Health Sci. 2022;16(10):796-803.

Hmar L, Brahmacharimayum S, Golmei N, Moirangthem M, Chongtham S. Comparison of 3% saline versus normal saline as a diluent for nebulization in hospitalized children with acute bronchiolitis: a randomized clinical trial. Journal of Medical Society. 2020;34(2):86-.