Nebulized Hypertonic Saline for Acute Bronchiolitis in Infants?

The current standard of care for acute bronchiolitis in infants is supportive care, as studies show limited benefit from bronchodilators, steroids, antibiotics, and antivirals. Studies of nebulized hypertonic saline (3%–6%) have shown mixed results, and the American Academy of Pediatrics does not recommend it for outpatients. These authors conducted a robust systematic review to determine whether treatment with nebulized hypertonic saline decreases hospital admissions and length of stay and improves illness severity scores.

The authors identified 24 trials (all but one were randomized controlled trials) involving roughly 3200 infants up to 24 months of age with acute bronchiolitis. In a meta-analysis of pooled data, the benefits of nebulized…