Try the modernized beta website. Learn more about the modernization effort.
Working… Menu

Efficacy of 3% Hypertonic Saline in Acute Viral Bronchiolitis (GUERANDE)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01777347
Recruitment Status : Completed
First Posted : January 28, 2013
Last Update Posted : July 28, 2014
Information provided by (Responsible Party):
Assistance Publique - Hôpitaux de Paris

Brief Summary:
The purpose of this study is to determine whether nebulized hypertonic saline solution reduces the admission rate 48 hours after initial treatment in the emergency department, when compared to normal saline solution (control).

Condition or disease Intervention/treatment Phase
Acute Viral Bronchiolitis Drug: 3% Saline Drug: 0.9% Normal Saline Phase 3

Detailed Description:

Acute viral bronchiolitis remains a significant cause of hospitalization and to date, no treatment reduce the rate of hospitalization. The only accepted treatment for bronchiolitis is nasal cleaning, hydration and for hospitalized hypoxemic infants, oxygen administration.

Several studies shown that nebulization of hypertonic saline solution reduce length of stay in hospital for hospitalized infant but effect on rate of hospitalization remains unclear.

The investigators propose a randomized double blind multicenter clinical trial on infants 6 weeks to 12 months old with moderate or severe bronchiolitis, in 21 emergency departments of hospitals situated France, during 2 winter seasons.

The investigators hypothesize that infants with bronchiolitis treated with nebulized hypertonic 3% saline solution would have less risk of being hospitalized. Our principal objective is to determine if nebulized 3% hypertonic saline solution reduces admission rate 24 hours after treatment compared to placebo.

Secondary objectives are to compare between groups intensity of respiratory symptoms measured by RDAI clinical score, duration of symptoms, length of hospital stay for hospitalized infants, adverse effects and health care utilization.

Patients presenting to the Emergency Department with a diagnosis of moderately severe bronchiolitis will be approached for entry into the study. After the initial routine assessment, informed consent will be obtained and the infant will be randomized to receive treatment in a double-blinded fashion 4 ml of nebulized study solution either 3% hypertonic saline (HS, study group) or 0.9% saline (NS, control group) every 20 minutes for a total of 2 doses. After an observation period of 20 minutes following the last dose, the infant will be reassessed by the attending physician in the ER for disposition (admit, discharge home). All subsequent therapy, if needed, will be at the sole discretion of the attending physician. The family of each recruited subject will be contacted by phone 2, 7, 14 and 28 days later to assess resolution of symptoms.

Clinical response to the above treatment will also be determined independently by the study physician utilizing a standardized respiratory scoring system, the Respiratory Distress Assessment Instrument (RDAI), at study entry and after each nebulization. The primary outcome measure is the rate of admission to hospital between the study and control groups 24 hours after inclusion. Secondary outcomes measure will involve the assessment of change in the RDAI between study entry and post-treatment, adverse effects, length of stay for hospitalized infant and health care utilization.

Layout table for study information
Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 778 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: 3% Hypertonic Saline to Reduce Hospitalization Rate in Acute Viral Bronchiolitis: a Randomized Double Blind Clinical Trial
Study Start Date : October 2012
Actual Primary Completion Date : April 2014
Actual Study Completion Date : April 2014

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: 3% Saline
Nebulized 3% Saline
Drug: 3% Saline
Two 4 mL nebulization of 3% saline with 20 minutes interval
Other Name: 3% Hypertonic Saline Solution for Inhalation (Mucoclear 3%)

Placebo Comparator: 0.9% Normal Saline
Nebulized 0.9% normal saline
Drug: 0.9% Normal Saline
Two 4 mL nebulization of 0.9% normal saline with 20 minutes interval
Other Name: 0.9% Saline Solution for Inhalation

Primary Outcome Measures :
  1. Admission rate [ Time Frame: 24 hours ]

Secondary Outcome Measures :
  1. change in RDAI score [ Time Frame: 2 hours ]
  2. Number of Participants with Adverse Events [ Time Frame: 2 hours ]
  3. length of hospitalization for hospitalized infant [ Time Frame: 1 month ]
  4. health care utilisation [ Time Frame: 1 month ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

Layout table for eligibility information
Ages Eligible for Study:   6 Weeks to 12 Months   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Age 6 weeks through 12 months
  • First moderate to severe episode of acute viral bronchiolitis (history of viral upper respiratory tract infection plus wheezing and/or crackles on chest auscultation with respiratory distress ).
  • Admission in Emergency Department
  • Parental/guardian permission (informed consent)

Exclusion Criteria:

  • prematurity < 37 weeks
  • artificial ventilation in the neonatal period
  • Chronic lung or heart disease
  • history of immunodeficiency
  • past use of nebulized HS
  • initial need for intensive care of assisted ventilation
  • Non-French speaking parent/guardian

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01777347

Show Show 21 study locations
Sponsors and Collaborators
Assistance Publique - Hôpitaux de Paris
Layout table for investigator information
Principal Investigator: Vincent Gajdos, MD, PhD Assistance Publique Hôpitaux de Paris - Paris Sud Medical School
Publications automatically indexed to this study by Identifier (NCT Number):
Layout table for additonal information
Responsible Party: Assistance Publique - Hôpitaux de Paris Identifier: NCT01777347    
Other Study ID Numbers: IDRCB 2012-A00228-35
P110143 ( Other Identifier: AP-HP )
AOM11036 ( Other Identifier: AP-HP )
First Posted: January 28, 2013    Key Record Dates
Last Update Posted: July 28, 2014
Last Verified: July 2014
Keywords provided by Assistance Publique - Hôpitaux de Paris:
Acute Viral bronchiolitis
Hypertonic saline
Hospital admissions
Additional relevant MeSH terms:
Bronchiolitis, Viral
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Respiratory Tract Infections
Virus Diseases
Additional relevant MeSH terms:
Layout table for MeSH terms
Bronchiolitis, Viral
Respiratory Tract Infections
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Lung Diseases
Virus Diseases
Pharmaceutical Solutions