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

Abstract

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. This study was conducted to evaluate the efficacy of nebulized Magnesium Sulphate instead of normal saline along with salbutamol in treating acute bronchiolitis. 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 a case record form. Data analysis was done by SPSS 24. Results: The mean age was 9.90±4.49 and 9.94±4.56 months 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, non invasive 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.