Comparative evaluation of nebulised 3% saline versus nebulised 0.9% saline in the treatment of acute bronchiolitis

Pragalatha Kumar A., Indhuja Rajarathinam, Aruna Gowdra


Background: Acute bronchiolitis is the most common respiratory tract infection in young children. Despite the high prevalence of acute bronchiolitis, no consensus exists on the management. Studies have shown that except oxygen therapy, no other treatment found to be effective. Hence, the present study was conducted to find out the efficacy of nebulised 3% saline versus is 0.9% saline for the treatment of acute bronchiolitis.

Methods: A prospective randomized controlled study of 150 children between the age group of 2 months to 24 months with signs and symptoms of Acute Bronchiolitis admitted to Indira Gandhi Institute of Child Health, Bangalore from January 2016 to December 2016 formed the study group, they were randomized into 2 groups, one received 3% saline nebulization and the other received 0.9% saline.

Results: A total of 150 children were enrolled in the study, 75 children (group A) received 0.9% saline and 75 children (group B) received 3% saline. At 24 hours, the mean clinical severity score for group A was 2.49±1.03 and group B was 2.16±0.49 (P=0.013). The duration of hospital stay was shorter (1-3 days) in 3% saline with a mean of 2.35 days and was longer (3-5 days) in 0.9% saline with mean value of 4.04 days which was statistically significant (p <0.001).

Conclusions: 3% saline nebulization can be used as an effective treatment for acute bronchiolitis. It significantly reduced the clinical severity score and length of hospital stay compared to 0.9% normal saline.


0.9% normal saline, Bronchiolitis, Nebulised 3% saline

Full Text:



Christopher A Green, David Yeates, Allie Goldacre, Charles Sande, Roger C Parslow, et al. Admission to hospital for bronchiolitis in England: trends over five decades, geographical variation and association with perinatal characteristics and subsequent asthma. Arch Dis Child. 2016;101:140-6.

Scottish Intercollegiate Guidelines Network. Bronchiolitis in children. A national clinical guideline. Scotland. 2006. Available at:

Rudolph CD, Rudolph AM, Hostetter MK, Lister G, Siegel NJ. Rudolph's Pediatrics. 21st ed. 2003:716-721.

Zorc JJ, Hall CB. Bronchiolitis: recent evidence on diagnosis and management. Pediatr. 2010;125:342-349.

Carvalho WBD, Johnston C, Fonseca MCM. Bronchiolitis and Pneumonia. Roger’s Textbook of Intensive Care. 4th ed. Philadelphia: Wolters Kluwer Lippincott Williams & Wilkins. 2008:716-721.

Wang EE, Milner RA, Navas L, Maj H. Observer agreement for respiratory signs and oximetry in infants hospitalized with lower respiratory infections. Am Rev Respir Dis. 1992;145(1):106-9.

Malik G, Singh A, Singh K, Pannu MS, Singh P, Banga S, Jain R. A comparative study to assess the effects of nebulised 3% hypertonic saline, 0.9% normal saline and salbutalmol in management of acute bronchiolitis among Indian children. J Evolution Med Dental Sci. 2015;2278-4802.

Khanal A, Sharma A, Basnet S, Sharma PR, Gami FC. Nebulised hypertonic saline (3%) among children with mild to moderately severe bronchiolitis-a double blind randomized controlled trial. BMC Pediatr. 2015 Dec;15(1):115.

Mandelberg A, Amirav I. Hypertonic saline or high volume normal saline for viral bronchiolitis: mechanisms and rationale. Pediatr Pulmonol. 2010;45(1):36-40.

Tal G, Cesar K, Oron A, Houri S, Ballin A, Mandelberg A. Hypertonic saline / epinephrine treatment in hospitalized infants with viral bronchiolitis reduces hospitalization stay: 2 years experience. Isr Med Assoc J. 2006;8(3): 169-73.

Kuzik BA, Al Qadhi SA, Kent S, Flavin MP, Hopman W, Hotte S, et al. Nebulized hypertonic saline in the treatment of viral bronchiolitis in infants. J Pediatr. 2007;151(3):266-70.

Luo Z, Fu Z, Liu E, Xu X, Fu X, Peng D, et al. Nebulized hypertonic saline treatment in hospitalized children with moderate to severe viral bronchiolitis. Clin Microbiol Infect. 2011;17(12):1829-33.