Role of Nebulized Epinephrine Versus Nebulized Hypertonic Saline in Moderate Bronchiolitis

Objective: To compare the nebulized epinephrine versus hypertonic saline solution in patients presenting with moderate bronchiolitis in terms of mean length of hospital stay. Study Design: Randomized Controlled Trial. Duration and Place of Study: This study was conducted at the Pediatrics Department of POF Hospital, Wah Cantt, from November 2023 to May 2024. Methodology: A total of 144 patients aged 1 day to 24 months with moderate bronchiolitis were randomized into two groups: Group I (nebulized racemic epinephrine) and Group II (3% hypertonic saline). Group I received 0.2 mL racemic epinephrine (USP 2.25%) diluted with 1.8 mL distilled water every 6 hours, while Group II received 2.0 mL hypertonic saline nebulization every 1–4 hours as needed. Vital signs, oxygen saturation, and adverse events were monitored, and length of hospital stay was documented. Results: Group I had a mean age of 10.06±6.98 months and Group II 12.50±6.97 months. The mean hospital stay was significantly shorter for Group I (3.943±0.14 days) compared to Group II (4.800±0.08 days, p=0.000). Stratification by feeding type revealed consistent trends favoring Group I, with breastfed patients showing stays of 3.956±0.15 days in Group I versus 4.800±0.09 days in Group II (p=0.000). Similarly, bottle-fed and other feeding types followed the same pattern. conclusion: Nebulized epinephrine exhibits greater clinical efficacy in the management of pediatric bronchiolitis, resulting in significantly reduced hospital stays compared to hypertonic saline. These findings provide critical insights into pediatric respiratory care, highlighting the necessity of targeted therapeutic approaches for optimizing patient outcomes.