In August 2017, Angoulvant and colleagues published the results of a randomized controlled trial in JAMA Pediatrics titled “Effect of Nebulized Hypertonic Saline Treatment in Emergency Departments on the Hospitalization Rate for Acute Bronchiolitis”. The trial included 777 infants presenting in the Emergency Department with a first episode of acute bronchiolitis, but who were otherwise healthy. The results suggest that hospital admission rates were statistically similar for the two modalities with 48.1% of infants in the Hypertonic Saline group admitted by 24 hours and 52.2% of infants admitted in the Normal Saline group (adjusted risk difference, –3.2%; 95%CI, –8.7%to 2.2%; P = .25).
Additionally, the trial found that mild adverse events occurred 8.9% of the time in the Hypertonic Saline group and only 3.9% of the time in the Normal Saline group. No serious adverse events occurred with either treatment though the authors note that their results strongly argue against the use of Hypertonic Saline treatment for the type of studied population from a risk-benefit perspective.
Hypertonic Saline has been used in bronchiolitis treatment because it rehydrates the airway mucosa and promotes mucociliary clearance.1
Another well-modelled method of hydration is by inspiration of heated humidified conditioned gas.2 Vapotherm Hi-VNI® Technology delivers an optimal blend of heated and humidified gas to mobilize secretions, protect airway mucosa, and promote bronchodilation.