Outcome of N-Acetylcysteine Nebulization Versus Salbutamol Nebulization in Children with Acute Bronchiolitis

Abstract

Background: A substantial proportion of children will experience at least one episode with bronchiolitis, and as much as 2-3% of all children will be hospitalized with bronchiolitis during their first year of life. Bronchiolitis is the most common reason for hospitalization of children in many countries, challenging both economy, area and staffing in paediatric departments. Objective: To determine outcome (in terms of clinical severity score and hospital stay) of N-acetylcysteine nebulization versus salbutamol nebulization in children with acute bronchiolitis. Material and Methods: The study cases were randomly divided into 2 groups by draws methods. Group A, each child was nebulized with 20 mg NAC in 3 ml of 0.9% of saline while group B was nebulized with 2.5 mg salbutamol in 3 ml of 0.9% saline solution. Patients of each group were nebulized three times a day (8 hours apart) for 5 days. These patients were closely monitored for the severity of the disease daily and clinical severity score was employed to record any improvement in both cases.  All the data was entered and analyzed using SPSS-18. Results: Of these 390 study cases, 228 (58.5%) were boys while 162 (41.5%) were girls. Mean age of our study cases was 7.92 ± 5.18 months . Most of the study cases i.e. 264 (67.7%) were from poor social background and mothers of most of these children were less educated as 85.6% of the mothers of these children were having their educational status equal/less than matriculation. Mean hospital stay in our study was 4.73 ± 0.829 days. Mean baseline clinical severity score was 5.52 ± 813. Mean clinical severity score after therapy was 1.85 ± 0.812 (with minimum clinical severity score was 1 while maximum was score was 4). Clinical severity score in group A was 1.21 ± 0.405 while in group B was 2.49 ± 0.578 (p= 0.000). Conclusion: Our study results support the use N – acetylcysteine nebulization in children with acute bronchiolitis as compared with salbutamol nebulization. N – acetylcysteine nebulization was found to be more effective in improving clinical severity score and reducing duration of hospitalization. Its use was safe, reliable and no adverse side effects were noted.

Keywords: Acute Bronchiolitis, Salbutamol, N – acetylcysteine.