Acta Scientific Paediatrics (ISSN: 2581-883X)

Research Article Volume 3 Issue 4

Efficacy of Nebulized 3% Hypertonic Saline Versus Epinephrine in the Treatment of Acute Bronchiolitis

Sunil Kumar Jatana1* and Kuldeep Mertiya2

1Professor Pediatrics, Melaka Manipal Medical College, Melaka, Malaysia
2Specialist in Pediatrics, Hospital Ambala, Haryana, India

*Corresponding Author: Sunil Kumar Jatana, Professor Pediatrics, Melaka Manipal Medical College, Melaka, Malaysia.

Received: February 24, 2020; Published: March 20, 2020

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Background: Acute bronchiolitis is a common lower respiratory tract infection in infants. There is no specific treatment available for this condition though many modalities of supportive treatment are recommended including normal saline, 3% saline nebulization and adrenaline nebulization.

Methods: A randomized trial was conducted over a period of 20 months. The study population included all children of 02 months to 24 months of age who were admitted to the hospital with a diagnosis of acute bronchiolitis. All children were randomized into two groups, one group was given nebulized epinephrine (1:1000,0.5 ml/kg subject to a max of 2.5 ml with 3 ml saline) and other group was given 3% hypertonic saline (4 ml) via nebulizer along with oxygen at 10, 30, 60 minutes, 4hrs, 8hrs and 12 hours of hospital admission. Assessment of all four parameters i.e. respiratory distress assessment instrument (RDAI) score, heart rate (HR), respiratory rate (RR) and oxygen saturation by pulse oximetry (SpO2) was done at admission and then after each nebulization at 10, 30, 60 minutes, 4hrs, 8hrs and 12 hours of hospital admission. The results were statistically analyzed by using ANOVA test and student ‘t’ test Trend analysis was also used to study the trend in the subsequent observations for all the four parameters i.e. RDAI score, HR, RR and SpO2 in both the study groups.

Results: There were total 60 children in the study, 30 in each of the groups 1 and 2. 49 children (81.7%) were of age less than 13 months. 11 children (18.3%) were between the age of 13 months to 24 months. At admission mean RDAI score was 14 in epinephrine group and 13 in hypertonic saline group. After nebulization at 10, 30, 60 min, 4hr, 8hr, 12hr of admission, RDAI score was 13,12,12,10,9,9 respectively in epinephrine group and 14,13,12,11,10,9,9 respectively in hypertonic saline group. There was no statistically significant difference (p value > .05 at). There was improvement in heart rate (HR) in both the groups after intervention. At admission mean HR was 162 per minute in epinephrine group and 164 per minute in hypertonic saline group. After nebulization at 10, 30, 60min, 4hr, 8hr, 12hr of admission, heart rate was 156,150,145,138,134,128 per minute respectively in epinephrine group and 158,153,148,141,137,131 per minute respectively in hypertonic saline group. Again, there was no statistically significant difference (p value > .05). At admission mean RR was 73 per minute in epinephrine group and 74 per minute in hypertonic saline group. After nebulization at 10, 30, 60min, 4hr, 8hr, 12hr of admission respiratory rate was 69, 66, 63, 59, 55, 51 per minute respectively in epinephrine group and 70, 66, 62, 58, 55, 51 per minute respectively in hypertonic saline group and there was no statistically significant difference (p value > .05). At admission mean SpO2 was 92% in epinephrine group and 91% in hypertonic saline group. After nebulization at 10, 30, 60min, 4hr, 8hr, 12hr of admission, SpO2 was 93, 94, 96, 97, 98, 99 percent respectively in epinephrine group and 93, 94, 96, 97, 99, 99 percent respectively in hypertonic saline group, there being no statistically significant difference (p value > .05) between the 2 groups).

Conclusion: Both the modalities of treatment i.e. 3% nebulized saline and nebulized adrenaline were equally efficacious in the treatment of acute bronchiolitis in children between 2 months to 2 years of age. There was no statistically significant difference between the two.

Keywords: Acute bronchiolitis; Infection; Hypertonic Saline Group

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References

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Citation

Citation: Sunil Kumar Jatana and Kuldeep Mertiya. “Efficacy of Nebulized 3% Hypertonic Saline Versus Epinephrine in the Treatment of Acute Bronchiolitis”. Acta Scientific Paediatrics 3.4 (2020): 30-35.



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