Inhaled hypertonic saline increases sputum expectoration in cystic fibrosis.
OBJECTIVE
To determine whether inhalation of hypertonic saline (HS) increases sputum expectoration in patients with cystic fibrosis (CF).


METHODS
Ten adolescents with CF, who were receiving inpatient treatment for a pulmonary exacerbation, were enrolled in a controlled cross-over clinical trial. After inhalation of beta adrenergic drug to prevent possible broncho-constriction, each patient inhaled for 10 min either 0.9% isotonic saline (IS) or 6% HS prior to routine physiotherapy. The following day the patient received the alternative solution. Seven patients undertook a second block after 1-5 days. Outcome measures included weight of sputum, a visual analogue score to assess the subjective feeling of a cleared chest after physiotherapy, and spirometry.


RESULTS
Sputum expectoration (median; Q1,Q3) from the beginning of the inhalation of HS or IS to the final spirometry measure 60 min post-physiotherapy was significantly greater after HS than IS [17.2g (11.7, 34.8) vs 11.3g (6.5, 16.1): P = 0.006]. A clinical score of the patient's own judgement of a cleared chest was significantly better after HS than IS. Spirometry results did not change following either of the two inhalations.


CONCLUSIONS
These data show that the inhalation of 6% HS prior to physiotherapy can increase sputum expectoration in patients with CF and suggest that HS might be an effective, safe and cheap adjunct to regular physiotherapy in patients with CF.
Riedler
J
J
Department of Thoracic Medicine, Royal Children's Hospital, Parkville, Victoria, Australia.
Reade
T
T
Button
B
B
Robertson
C F
CF
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities / Q000379:methods*; D010865:Pilot Projects; D012129:Respiratory Function Tests; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D013183:Sputum / Q000502:physiology*; D018709:Statistics, Nonparametric
D012462:Saline Solution, Hypertonic