Salbutamol Nebulisation in Normal Saline versus Salbutamol Nebulisation in Hypertonic Saline (3%) in Children with Acute Asthma Exacerbation: An Open-labelled Randomised Controlled Trial
Introduction: Asthma has a significant impact and is the leading cause of morbidity and mortality in children. Salbutamol has been the cornerstone of treatment for bronchial constriction in asthma. Conventionally, salbutamol is diluted in Normal Saline Solution (NSS) and used for nebulisation. Studi...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-05-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/20986/75315_CE[Ra1]_F(SL)_PF1(VD_SL)_redo_PFA(IS)_PB(AnS_IS)_PN(IS).pdf |
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| Summary: | Introduction: Asthma has a significant impact and is the leading cause of morbidity and mortality in children. Salbutamol has been the cornerstone of treatment for bronchial constriction in asthma. Conventionally, salbutamol is diluted in Normal Saline Solution (NSS) and used for nebulisation. Studies conducted on bronchiolitis have demonstrated that using hypertonic saline instead of Normal Saline (NS) can decrease the viscosity of secretions and thus clear the airways.
Aim: To compare the efficacy of salbutamol nebulisation in NS versus salbutamol nebulisation in hypertonic (3%) saline in children with acute asthma exacerbation.
Materials and Methods: This open-labelled randomised controlled trial was conducted in the Department of Paediatrics at Pandit BD Sharma Post Graduate Institute of Medical Science, Rohtak, Haryana, India. The study involved 200 children between the ages of 5 and 14 years who presented with acute asthma exacerbation at the same institute from November 2022 to October 2023. A scoring system, the Becker asthma severity score, was used to classify the children as having mild/moderate or acute severe asthma. The study sample was divided into two groups: Group A (Control group: Salbutamol nebulised with NS) and Group B {(Study group: Salbutamol nebulised with Hypertonic Saline (HS))}. Both groups were compared in terms of improvement in symptoms using the Paediatrics Respiratory Assessment Measure (PRAM) score, duration of hospital stay and the requirement for admission to the Paediatrics Intensive Care Unit (PICU). An unpaired t-test and Chi-square test were performed, and the p-value was calculated, with a significance level set at <0.05.
Results: In the present study, both groups were comparable in terms of age, gender (p=0.039), socioeconomic status, and residence. The Paediatric Respiratory Assessment Measure (PRAM) score was comparable in the hypertonic saline and NS groups at the beginning. However, the PRAM score was significantly lower in the hypertonic saline group compared to the NS group at 20 minutes (6.12±1.26 versus 6.84±1.13), 40 minutes (4.85±0.83 versus 5.14±1.00), and 60 minutes (3.14±0.64 versus 3.87±0.65). The PICU admission rate was significantly lower in the hypertonic saline group (24.6%) compared to the NS group (75.4%). A higher number of patients in the hypertonic saline group were discharged within 24 hours compared to the NS group.
Conclusion: The 3% hypertonic saline group, in comparison with the 0.9% NS group, showed greater efficacy in relieving symptoms and reducing the length of hospital stay in children with acute exacerbation of asthma. |
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| ISSN: | 2249-782X 0973-709X |