Abstract
Objective: The objective of the study was to compare the effects of nebulized 3% hypertonic saline and nebulized levosalbutamol in the management of bronchiolitis.
 Methods: Seventy children of age 1–24 months admitted into the hospital with the diagnosis of bronchiolitis. Participants were divided into two groups of 35 each. Group A was given nebulized 3% hypertonic saline and Group B was given nebulized levosalbutamol. Modified respiratory distress assessment instrument (RDAI) is used at admission, at 48 h after admission, and at the time of discharge to identify the reduction in scores between two groups.
 Results: The mean age of patients in the study population was 10.1±6.4 months. The mean birth weight of patients in Group A and Group B was 3.00±0.61 and 3.12±0.75. The percentage of male patients was 57.1% and the percentage of female patients was 42.8%. The modified RDAI score in Group A and Group B at admission, 48 h of admission, and at the time of discharge was 4.34±0.87, 2.4±1.03, and 0.67±0.05 (p=0.04) and 4.11±0.58, 3.60±1.00, and 2.51±0.96 (p=0.12). The hospital stay was observed to be lowered in Group A (3.77±0.88) compared to Group B (5.43±0.92; p=0.04).
 Conclusion: From the findings of our study, we conclude that nebulized 3% hypertonic saline, as it acts by hindering the pathophysiologic mechanism of bronchiolitis, is more effective in reducing the clinical severity score and length of hospital stay. Further 3% hypertonic saline also have the additional benefit of decreasing the economic burden of disease as it is safe, inexpensive, reduces the inpatient hospital charges by reducing the length of stay.
Highlights
Bronchiolitis, an infection of the lower respiratory tract, is a common viral infection affecting the children below 2 years of lifetime
The familiar viruses to cause bronchiolitis infection include respiratory syncytial virus, parainfluenza, influenza, rhinovirus, adenovirus, and metapneumovirus and bacteria like Mycoplasma pneumoniae have been implicated in the etiology of bronchiolitis [2,3,4]
The modified respiratory distress assessment instrument (RDAI) score in nebulized 3% hypertonic saline and nebulized levosalbutamol at admission, 48 h after admission, and at the time of discharge was 4.34±0.87, 2.4±1.03, and 0.67±0.05 (p=0.04) and 4.11±0.58, 3.60±1.00, and 2.51±0.96 (p=0.12) (Table 2)
Summary
Bronchiolitis, an infection of the lower respiratory tract, is a common viral infection affecting the children below 2 years of lifetime. It is the principal cause of hospitalization, with remarkable morbidity and mortality in both advanced and growing countries [1]. Within the first 2 years of life, more than onethird of children suffer from bronchiolitis, among them 1 out of 10 infants require hospitalization [7,8]. Mortality rate of bronchiolitis is 0.5–1.5% among hospitalized children which is elevated to 3–4% in case of children suffering with cardiopulmonary complications [9]. About 95% of the bronchiolitis cases occur in the growing countries, across the world [6]. In India it is a significant problem due to high incidence and its associated health and economic impact [10,11]
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