Exploring the role of saline nebulization in bronchiolitis: Clinical recovery, MRDAI scores, and hospital outcomes

Abstract

Background: Respiratory Syncytial Virus (RSV) bronchiolitis is a significant cause of lower respiratory tract infections in infants, particularly those under two months. Supportive care is the cornerstone of management. Nebulized normal saline (0.9% sodium chloride) is often used in clinical practice, sometimes as a control in studies, but its specific impact on this age group warrants detailed documentation. Objective: This study aimed to characterize the clinical course, respiratory distress changes, and hospital outcomes in infants under two months of age with RSV-positive bronchiolitis who received nebulized normal saline as part of their care. Methods: This analysis focuses on the control group (Normal Saline-NS) of a randomized controlled trial, which included 45 infants aged ≤60 days with RSV-positive bronchiolitis. Participants in this group received nebulized 0.9% normal saline (3ml) every 8 hours. Outcomes assessed included Modified Respiratory Distress Assessment Instrument (MRDAI) scores, oxygen saturation (SpO₂), duration of oxygen therapy, and length of hospital stay. Descriptive statistics were used to present the findings. Results: The mean age of participants in the NS group was 39.21±1.50 days; 71.11% were male. MRDAI scores showed a reduction from a baseline of 6.82±1.30 to 2.31±0.13 by Day 4, with a mean difference of 4.49±1.09. SpO₂ at admission was 91.68±1.70%, and 92.16±0.14% after 24 hours. The average duration of oxygen therapy was 11.54±1.46 hours. Rapid recovery (within 72 hours) occurred in 48.8% of cases. The mean hospital stay was 79.64±3.69 hours. Conclusion: In infants ≤2 months with RSV-positive bronchiolitis, nebulized normal saline administered as part of supportive care was associated with a gradual improvement in respiratory distress and clinical recovery. These findings provide a detailed account of outcomes in this patient group receiving standard supportive management including normal saline nebulization.