Wednesday, 07. November 2012

First study shows: Hypertonic saline improves...

...clinical outcomes in preschoolers with acute wheezing

The research group of Dr. Mandelberg showed firstly in a randomized trial that preschool children with acute wheezing have a shorter stay in the emergency department (ED) and are less likely to be hospitalized if their treatment includes inhaled hypertonic saline (HS)1.

Virus-induced wheezing is a common cause of emergency department visits for children. Symptoms like shortness of breath and difficulty of exhaling often do not respond well to common treatments like bronchodilators and corticosteroids2.

HS is already an established therapeutic approach in the treatment of cystic fibrosis (CF). Therefore Ater et al. evaluated the effect of hypertonic saline in the new indication of wheezing preschool children.

The study involved 41 children ranging in age from 1-6 years (mean age 31.9 months) visiting the ED with acute wheezing episodes.

Children were randomized to inhale 5% hypertonic saline 4 ml mixed with albuterol (HS group) or normal saline 4 ml mixed with albuterol (NS group) twice every 20 minutes and then 4 times daily if the child was hospitalized.


  • The admission rate to the hospital decreased significantly in the HS group vs. NS group (62.2% vs. 92%); p<0.05
  • Length of hospital stay in the HS-group decreased significantly (2 vs. 3 days); p=0.027
  • Both groups showed comparable and significant improvements of the clinical score (validated score for wheezing symptoms)

Diagramm - Alter

The admission rate was significantly lower in the HS-group than in the NS group: 62.2% vs. 92% (p<0.05)1

This study successfully introduced the use of hypertonic saline in the therapy of wheezing children. Hypertonic saline helped to reduce significantly the admission rate and length of hospital stay. Although more studies are needed, hypertonic saline has the potential to become an important option even for the treatment of acute wheezing.

1 Ater et al; Pediatrics 2012 Jun;129(6):e1397-403
2 Panickar et al; N Engl J Med. 2009 Jan 22;360(4):329-38