Bronchiolitis Clinical Trial
Official title:
Nebulized Hypertonic Saline for Treatment of Viral Bronchiolitis
This study aims to examine the effect of nebulized 3% hypertonic saline in the treatment of viral bronchiolitis. The investigators hypothesize that nebulized 3% saline will decrease rate of hospital admission, decrease clinical severity scores, and decrease length of stay.
Bronchiolitis is the most common viral respiratory infection in young children and infants.
It is responsible for hundreds of thousands of outpatient visits and hospitalizations every
year. Hypertonic saline may decrease swelling in the lung tissue, improve the patient's
ability to clear secretions, and decrease nasal congestion. Hypertonic saline nebulizations
have already been used effectively in patients with cystic fibrosis and in a few small
trials on infants with bronchiolitis. Patients who come to the emergency department or
inpatient ward of two urban free-standing pediatric hospitals in California between December
and April and are diagnosed with bronchiolitis will be randomized into two groups- the
control group will receive nebulized 0.9% normal saline, while the study group will receive
nebulized 3% hypertonic saline. Nebulizations will be pretreated with albuterol, to prevent
the theoretical risk of increased wheezing in patients with undiagnosed underlying asthma.
Patients will be given up to 3 nebulizations in the emergency department, after which time
the attending physician will decide whether admission to the hospital is required. Patients
who are admitted will continue to receive the same nebulized treatment every 8 hours until
discharged. Additional interventions such as epinephrine treatments and antibiotics can be
ordered as indicated by the patient care team.
Investigators will measure symptom severity before and after treatments using the
respiratory distress assessment instrument (RDAI). The investigators will compare rates of
being admitted to the hospital in each group. The investigators will also compare RDAI
scores, average length of stay, number of additional respiratory treatments needed, number
of hours requiring oxygen, amount of IV fluid needed, and frequency of adverse effects. The
investigators hypothesize that nebulized hypertonic saline will be a safe, cost-effective,
and efficacious therapy which can be utilized in the outpatient setting to prevent hospital
admission, as well as decrease length of stay for patients who require admission. Given the
significant disease burden of viral bronchiolitis, the potential impact is substantial.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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