EFFICACY OF NEBULIZED 3% HYPERTONIC SALINE WITH OR WITHOUT SALBUTAMOL IN INFANTS HOSPITALIZED WITH ACUTE BRONCHIOLITIS: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Acute bronchiolitis is one of the leading causes of hospitalization in infants and young children. Nebulized 3% hypertonic saline (HS) has been proposed to improve mucociliary clearance, while the routine use of bronchodilators such as salbutamol remains controversial¹–³. Objective: To compare the efficacy and safety of nebulized 3% hypertonic saline with salbutamol versus 3% hypertonic saline alone in hospitalized children under two years with acute bronchiolitis. Methods: In this randomized controlled trial, 80 children aged 2–24 months hospitalized with acute bronchiolitis over a 2-year period were randomized into two groups. Group A received nebulized 3% HS with salbutamol, and Group B received nebulized 3% HS alone. The primary outcome was length of hospital stay (LOS). Secondary outcomes included change in clinical severity score, duration of oxygen therapy, ICU transfer, and adverse events. Results: Mean LOS was 3.1 ± 0.9 days in Group A and 3.3 ± 1.0 days in Group B (p = 0.28). Both groups demonstrated progressive clinical improvement over 72 hours, with no statistically significant intergroup difference. Minor adverse events were more frequent in the salbutamol group. Conclusion: The addition of salbutamol to nebulized 3% hypertonic saline did not confer significant clinical benefit over hypertonic saline alone in hospitalized infants with acute bronchiolitis.