title: Effect of increasing doses of hypertonic saline on mucociliary clearance in patients with cystic fibrosis.
abstract: BACKGROUND
  Patients with cystic fibrosis are known to have decreased mucociliary clearance. It has previously been shown that inhalation of a 7.0% solution of hypertonic saline significantly improved mucociliary clearance in a group of adult patients with cystic fibrosis. The aim of this study was to measure the response to increasing concentrations of inhaled hypertonic saline.
  
  
  METHODS
  Ten patients (seven men) of mean (SE) age 22 (4) years and mean forced expiratory volume in one second (FEV1) 52.0 (6.7)% predicted completed the study. Mucociliary clearance was measured using a radioaerosol technique for 90 minutes after the interventions which comprised 0.9% NaCl + voluntary cough (control), 3.0% NaCl, 7.0% NaCl, and 12% NaCl.
  
  
  RESULTS
  There was a significant increase in the amount of activity cleared from the right lung with all concentrations of hypertonic saline (HS) compared with control. The amount cleared at 90 minutes on the control day was 12.7% (95% confidence interval (CI) 9.8 to 17.2) compared with 19.7% (95% CI 13.6 to 29.5) for 3% HS, 23.8% (95% CI 15.9 to 36.7) for 7% HS and 26.0% (95% CI 19.8 to 35.9) for 12% HS. The improvement in mucociliary clearance was not solely due to coughing as the number of coughs recorded on the control day exceeded that recorded on any other day. The hypertonic saline did not induce a clinically significant change in FEV1.
  
  
  CONCLUSIONS
  Within the range of concentrations examined in this study, the effect of hypertonic saline appears to be dose dependent. Inhalation of hypertonic saline remains a potentially useful treatment for patients with cystic fibrosis.
authors.affiliation: Respiratory Investigation Unit, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Robinson
authors.forename: A L
authors.initials: AL
authors.lastname: Hemming
authors.forename: J A
authors.initials: JA
authors.lastname: Regnis
authors.forename: A G
authors.initials: AG
authors.lastname: Wong
authors.forename: D L
authors.initials: DL
authors.lastname: Bailey
authors.forename: G J
authors.initials: GJ
authors.lastname: Bautovich
authors.forename: M
authors.initials: M
authors.lastname: King
authors.forename: P T
authors.initials: PT
authors.lastname: Bye
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008297:Male; D009079:Mucociliary Clearance / Q000187:drug effects*; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D012462:Saline Solution, Hypertonic