Strong Salt Solution Kept Congested Kids Out of the Hospital

Hypertonic saline solution lowered risk of hospital admission for bronchiolitis

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Bronchiolitis is a common and often costly infection that frequently puts young children in the hospital. Now, it seems one treatment may help these kids avoid staying overnight at the hospital.

A recent study found that bronchiolitis patients under 2 years old were less likely to be admitted to the hospital after an emergency room visit if they were given hypertonic saline (a very concentrated salt solution) rather than normal saline.

The researchers discovered the type of saline that patients received did not significantly affect the amount of time they spent in the hospital.

"Tell a pediatrician if your child is congested."

The lead author of this study was Susan Wu, MD, from the Division of Hospital Medicine at Children’s Hospital Los Angeles and the Division of Hospital Medicine at the University of Southern California Keck School of Medicine in Los Angeles, California.

Bronchiolitis is a common lung infection among infants and young children that results in about 150,000 hospitalizations each year, with an estimated cost of $500 million. The condition occurs when the small airways in the lungs (called the bronchioles) become congested due to a virus.

This study included 408 children under the age of 2 years old who went to the emergency room for viral bronchiolitis at one of two children’s hospitals in California between March 1, 2008 and April 30, 2011.

The children’s average age was 7 months.

The researchers randomly gave the children either 0.9 percent normal saline or 3.0 percent hypertonic saline through an inhaler.

There were 197 patients in the normal saline group and 211 in the hypertonic saline group.

The patients were given 4 milliliters of hypertonic saline or normal saline up to three times during their emergency room visit. Those who were admitted to the hospital were given their medication every eight hours until they were discharged from the hospital.

The findings showed that 30 percent of the hypertonic saline group was admitted to the hospital, compared with 43 percent of the normal saline group.

The patients who received hypertonic saline were 51 percent less likely to be admitted to the hospital than the patients who received normal saline.

The average length of hospital stay among the normal saline group was 3.92 days, compared with 3.16 days for the hypertonic saline group.

The boys were 2.54 times more likely to be admitted to the hospital than the girls.

In addition, those younger than 6 months old were 28 percent less likely to be admitted to the hospital than those older than 6 months old.

“We found that infants and young children with bronchiolitis treated with nebulized hypertonic saline in the [emergency department] were less likely to require hospitalization,” Dr. Wu said in a press statement. “It’s gratifying to find an inexpensive yet effective therapy that helps patients while also reducing the cost of healthcare.”

This study was limited by the population size, which was smaller than desired, and there were significant differences in admission rate and length of stay at each hospital. Also, most of the patients were Hispanic, so the findings may not be generalizable to other populations.

Furthermore, the researchers did not account for the severity of patients' bronchiolitis, and hypertonic saline may have a different effect on different levels of disease severity. Lastly, each patient’s doctor was allowed to give the patients other treatments if they so decided.

This study was published on May 26 in JAMA Pediatrics.

The Thrasher Research Fund and the Department of Pediatrics at University of Southern California Keck School of Medicine provided funding.

Review Date: 
May 28, 2014
Last Updated:
May 29, 2014