Seven percent hypertonic saline--0.1% hyaluronic acid in infants with mild-to-moderate bronchiolitis

Pediatr Pulmonol. 2014 Sep;49(9):919-25. doi: 10.1002/ppul.22935. Epub 2013 Nov 4.


Objectives: Our study was aimed to evaluate the efficacy of 7% hypertonic saline and 0.1% hyaluronic acid (7% HS-HA) given by inhalation, in infants hospitalized for mild-to-moderate bronchiolitis.

Methods: In a double-blind controlled study, 39 infants (23 boys) <7 months of age (median age 2 months) were enrolled and randomly assigned to receive either nebulized 7% HS-HA (7%NaCl + 0.1%HA) (n:21) or 0.9 normal saline (NS) (n:18) at a dose of 2.5 ml twice a day for 3 days. All infants were assigned a clinical severity score at admission and four times daily during hospitalization. Main outcome measures were number of days hospitalization, safety and daily reduction in the severity score.

Results: No difference was found between the two groups for clinical severity score at admission. One child in the study group and two in the NS group interrupted the study protocol; 19% of infants in the study group and 11% in the NS group had mild cough after the aerosol. The length of stay in the control group and treatment groups were 4.8 ± 1.5 versus 4.1 ± 1.9 days, respectively (P = 0.09). There was a trend for shortening the hospitalization days in the treatment group by 14.6%. The use of NS in the control group was identified as an independent risk factor for length of hospital stay using the multivariate logistic regression model (P = 0.04). No difference was observed between the two groups for the clinical score reduction during the first 3 days hospitalization.

Conclusions: 7% HS-HA is a safe and effective therapy in treating infants hospitalized for mild-to-moderate bronchiolitis.

Keywords: 7% hypertonic saline; bronchiolitis; hospital treatment; hyaluronic acid; therapy.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Bronchiolitis / drug therapy*
  • Double-Blind Method
  • Female
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Infant
  • Length of Stay / statistics & numerical data
  • Male
  • Multivariate Analysis
  • Nebulizers and Vaporizers
  • Prospective Studies
  • Saline Solution, Hypertonic / administration & dosage*
  • Severity of Illness Index
  • Viscosupplements / administration & dosage*


  • Saline Solution, Hypertonic
  • Viscosupplements
  • Hyaluronic Acid