Abstract

Background: Acute bronchiolitis is a common viral respiratory infection in infants, causing wheezing, respiratory distress, and increased oxygen requirement. Management is mainly supportive, with limited effective pharmacological options. Nebulized 3% hypertonic saline may improve mucus clearance, while adrenaline may reduce airway edema. However, their comparative effectiveness remains uncertain, particularly in Bangladesh. This study aimed to compare their effects on oxygen requirement and clinical recovery in infants with acute bronchiolitis. Methods: A randomized controlled study was conducted at Ashiyan Medical College Hospital, Dhaka, from February to July 2025, involving 114 Children aged 2–12 months with acute bronchiolitis. Infants were randomly assigned to nebulized 3% hypertonic saline (n=57) or adrenaline (n=57), alongside standard supportive care. Oxygen requirement, clinical recovery, SpO?, respiratory rate, severity score, and hospital stay were assessed. Data were analyzed using SPSS 27.0, with p<0.05 considered significant. Ethical approval and parental consent were obtained. Results: Among 114 infants, baseline characteristics were comparable. Compared with adrenaline, 3% hypertonic saline significantly reduced oxygen requirement (32.6 vs. 40.8 hours; p=0.009), clinical recovery time (3.2 vs. 3.8 days; p=0.012), and hospital stay (3.7 vs. 4.3 days; p=0.018). SpO? at 24 hours was higher with hypertonic saline (94.3% vs. 93.5%; p=0.010). Recovery within 72 hours was higher with hypertonic saline (78.9% vs. 63.2%), but not statistically significant. No serious adverse events occurred, while tachycardia was less frequent with hypertonic saline (0% vs. 8.8%; p=0.023). Conclusion: 3% hypertonic saline reduced oxygen requirement, recovery time, and hospital stay compared with nebulized adrenaline and was well tolerated, suggesting a beneficial role in acute bronchiolitis.

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