Background Acute respiratory distress syndrome (ARDS) poses an obstacle for the medical field due to its high mortality rates. Aim We aimed to compare the effect of nebulized and intravenous (IV) injections of hypertonic saline (HTS) 3% on the management of ARDS patients. Patient and methods This randomized controlled study included 105 patients (aged 21–60 years, both sexes) with mild to moderate ARDS (PaO₂/FiO₂≥150). Patients were randomly assigned into three equal groups: group A (Control): standard ARDS protocol, group B: standard ARDS protocol + nebulized 3% HTS (5 ml every 8 h) with twice-daily plasma Na monitoring, group C: Standard ARDS protocol + IV 3% HTS (500 ml over 24 h), maintaining plasma Na at 145–150 mEq/l Results There was a significantly higher hypoxic index in group B and group C than in group A on days 6 and 7, with group B showing a greater increase than group C. On day 7, Murray’s score was considerably lower in group B compared with groups A and C. The need for mechanical ventilation and the length of ICU stay were substantially lower in groups B and C than in groups A. After 7 days, nevertheless, there was no substantial difference in the mortality rates of the three groups. Conclusions Nebulized and IV HTS 3% were convenient for patients with mild to moderate ARDS, as it improved clinical status, reduced lung injury score, the need for mechanical ventilation and increased oxygenation, and arterial oxygen saturation.
Elfakhrany et al. (Wed,) studied this question.