Inhaled hypertonic saline appears to have an edge over normal saline in reducing hospitalizations among infants and toddlers with bronchiolitis, researchers in California have learned.

Bronchiolitis is one of the most frequently encountered respiratory illnesses in infants and young children, as well as one of the costliest. Susan Wu, MD, and colleagues at Children’s Hospital Los Angeles and UCSF Benioff Children’s Hospital in Oakland compared the effect of nebulized 3% hypertonic saline with 0.9% normal saline on hospital admission rates and lengths of stay in children with bronchiolitis who were younger than age 24 months, reporting the results in JAMA Pediatrics.

The double-blind, randomized clinical trial spanned 3 consecutive bronchiolitis seasons from March 2008 through April 2011. The patients, all with a primary diagnosis of viral bronchiolitis, were seen in the emergency department (ED) of one of the two hospitals.

A total of 211 children were enrolled in the hypertonic saline group, with 197 in the normal saline group. Patients received their assigned intervention up to 3 times in the ED; those who were admitted to the hospital continued to receive the therapy every 8 hours until discharge.

According to the investigators, 42.6% of patients treated with normal saline required hospital admission, compared with 28.9% of the hypertonic saline group.

“It’s gratifying to find an inexpensive yet effective therapy that helps patients while also reducing the cost of health care,” commented study leader Wu in a statement issued by Children’s Hospital Los Angeles.