A Randomized controlled trial on the Efficacy of Nebulized Magnesium Sulphate versus Salbutamol with Normal Saline in the Treatment of Acute Bronchiolitis in Rajshahi Medical College Hospital

Background: Acute bronchiolitis is one of the important causes of hospitalization among infants in Bangladesh.Although this condition is common, there is no widely accepted evidence-based treatment approach.Methods: The hospital based randomized controlled trial was carried out at the department of Pediatrics, Rajshahi Medical College Hospital, Rajshahi for 12 months period.Total 100 children (2-24 months) presenting with first episode of acute bronchiolitis were enrolled in this study and randomly divided into two groups: Group-A (n=50) was nebulized with 2 ml Magnesium sulphate diluted with 2 ml normal saline and Group-B (n=50) was nebulized with 2 ml normal saline along with 0.15 mg/kg/dose salbutamol solution.Data collection was carried out by the investigator herself by using separated case record form.Data analysis was done by SPSS 24.Results: The mean age was 9.904.49and 9.944.56months for the Group-A and Group-B with male predominance in both groups (56.0% of Group-A and 76.0% of Group-B).Both groups were similar in terms of age, sex, baseline clinical manifestations (p>0.05).The mean heart rate (HR) was significantly lower in Group-A than that in Group-B during follow up (p<0.05).The mean respiratory rate (RR) and clinical severity score (CSS) were significantly lower in Group-A compared to Group-B(p<0.05).The mean SPO2 was notably higher in Group-A than in Group-B (p<0.05).The length of hospital stay was significantly higher for Group B in compared to group A (p<0.05).There was no significant difference between both groups in terms of secondary outcomes (hospital discharge, ICU admission, noninvasive ventilation and hospital stay).Conclusion: Significant improvement in clinical parameters was seen among the patients who received nebulization with MgSO4.Further multicenter studies may be carried out to recommend MgSO4 as a novel therapy for Bronchiolitis.