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Observation of the beneficial effects of nasal saline irrigation combined with inhaled budesonide on acute asthma exacerbations in children: a retrospective study

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  • Published: 02 November 2026
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BMC Pediatrics Aims and scope Submit manuscript
Observation of the beneficial effects of nasal saline irrigation combined with inhaled budesonide on acute asthma exacerbations in children: a retrospective study
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  • Qianru Zhao1,
  • Zhiyao Sun2,
  • …
  • Meng Li2&
  • Dong Shi 2

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Background

Acute asthma exacerbations remain a major cause of morbidity in children. While inhaled budesonide is a cornerstone of acute management, concurrent upper-airway inflammation may limit treatment efficacy. This study aimed to evaluate the clinical effects of nasal saline irrigation combined with inhaled budesonide in children with acute asthma exacerbations.

Methods

This retrospective study was conducted at Beijing Chaoyang Hospital, Capital Medical University. Children aged 1–14 years who were treated for acute asthma exacerbations were divided into a control group (inhaled budesonide alone) and a combination group (inhaled budesonide plus nasal saline irrigation). Clinical symptom scores, peripheral oxygen saturation (SpO₂), respiratory rate, length of hospital stay, and adverse events were compared between the two groups. The study was approved by the institutional ethics committee (BJCY-26-371).

Results

A total of 186 children were included (control group, n = 92; combination group, n = 94). Baseline characteristics were comparable between groups. The combination group showed significantly faster reductions in total and nasal symptom scores, more rapid improvement in SpO₂ and respiratory rate at 24–72 h, and a shorter median length of hospital stay (4.0 vs. 5.0 days, P = 0.003) compared with the control group. The requirement for additional systemic corticosteroids was also lower in the combination group. Nasal saline irrigation was well tolerated, with only mild, self-limiting adverse events reported.

Conclusions

Nasal saline irrigation combined with inhaled budesonide was associated with faster clinical improvement and a shorter hospital stay in children with acute asthma exacerbations compared with inhaled budesonide alone, without increasing adverse events. These findings support the potential value of nasal saline irrigation as a simple adjunctive therapy in this setting.

Keywords

Acute asthma exacerbation
Children
Budesonide
Nasal saline irrigation
United airway
Retrospective study

Acknowledgements

Not applicable.

Funding

The authors declare that no financial support was received for the research, authorship, and/or publication of this article.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Heping Hospital Affiliated to Changzhi Medical College, Changzhi City, Shanxi Province, 046000PR China

    Qianru Zhao

  2. Department of Urology, Beijing Chaoyang Hospital, affiliated with Capital Medical University, No. 8, Workers' Stadium South Road,Chaoyang District,Beijing, 100020, PR China.

    Zhiyao Sun , Meng Li & Dong Shi

Authors
  1. Simone Amaro Alves Romariz
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  2. Beatriz Pereira Tavares Marinelli
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  3. Maira F. C. Bergo
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  4. Maira L. Foresti
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  5. Luiz Eugenio Mello
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Corresponding author

Correspondence to Dong Shi.

Ethics declarations

Ethics approval and consent to participate

This retrospective study was approved by Beijing Chao-yang Hospital Human Research Ethics Committee (Approval No. BJCY2025-331). The requirement for informed consent was waived by the Ethics Committee because of the retrospective nature of the study and the use of anonymous data. All procedures were performed in accordance with the ethical standards of the institutional research committee and with the Declaration of Helsinki.

Consent for publication

Not Applicable.

Competing interests

The authors declare no competing interests.

Additional information

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Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

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  1. Luiz Eugenio Mello View author profile

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