Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C


OBJECTIVE: The objective of this selective EBM review is to determine whether or not nebulized hypertonic saline solution reduces hospital admission rates when compared to nebulized normal saline solution in children less than or equal to 24 months of age diagnosed with acute bronchiolitis in the emergency department setting.

STUDY DESIGN: Systematic review of three randomized, double-blind, placebo controlled trials in the English language all published in 2014.

DATA SOURCES: Data sources obtained for this review were articles published in peerreviewed journals found using PubMed Database.

OUTCOMES MEASURED: The outcome measured was hospital admission rate. Hospital admission rate is calculated as the number of patients requiring inpatient hospitalization divided by the total number of patients randomized.

RESULTS: Three double-blind randomized, controlled trials were included and analyzed in this review. The study by Wu et al showed a statistically significant reduction (p=0.01) in hospital admission rate with the administration of nebulized hypertonic saline compared to nebulized normal saline with a number needed to treat (NNT) of 9. The second study by Jacobs et al showed a decrease in admission rate with hypertonic saline that was not statistically significant compared to control. The third study by Florin et al showed a slight increase in hospital admission rate with the use of nebulized hypertonic saline compared to control that was not statistically significant.

CONCLUSIONS: The results of the randomized, controlled trials were conflicting. Future study is warranted to evaluate the efficacy of hypertonic saline in reducing hospital admission rate.