Context

Nebulised hypertonic saline for acute viral bronchiolitis was first brought to public scrutiny in 2002. It was previously shown to be effective in patients with cystic fibrosis, and the first study in bronchiolitis, a small outpatient trial where ambulatory children were given the medication repeatedly over 5 days, showed promise.1 Further studies followed, and a dichotomy has emerged, with inpatient studies reporting consistently positive impacts on length of stay2,–,6 and emergency department studies failing to find any impact on admission rates.7,–,9 It has been proposed that repeated treatments may be required before any benefit is observed because of a theoretical mechanism of action involving rehydration of the airway surface liquid.10 This study evaluated the clinical utility of the therapy in a short stay unit and attempted to establish …