Nebulised 7% hypertonic saline improves lung function and quality of life in bronchiectasis.
Sputum retention is a distressing feature of non-cystic fibrosis bronchiectasis and has been shown to contribute to the vicious cycle of infection seen in this disease. In a previous study we demonstrated that nebulised 7% hypertonic saline was both safe and effective in this patient population. Patients with a clinical diagnosis of non-cystic fibrosis bronchiectasis, confirmed by HRCT, were entered into a randomised single blind cross-over study to evaluate 0.9% sodium chloride (IS) and 7% hypertonic saline (HS). Following a 4 week run in patients received a random order active HS or IS daily for 3 months. A 4 week wash-out phase was included between phases. We report lung function, quality of life, and health care utilisation responses. 32 patients mean age 56.6 years (SD 14.6), 16 male, were recruited of which 28 were randomised and completed the study. Lung function (%change from baseline) improved in HS vs. IS (FEV(1): 15.1, 1.8 p<0.01; FVC: 11.2, 0.7 p<0.01. SGRQ improved significantly from baseline (HS 6.0, IS 1.2; p<0.05). There were reductions in annualised antibiotic usage (HS 2.4, IS 5.4 courses per patient per year), annualised emergency health care utilisation visits were reduced (HS 2.1, IS 4.9 events per patient per year). There were also improvements in sputum viscosity and ease of expectoration (visual analogue scale). Regular use of 7% hypertonic saline improves lung function, quality of life and health care utilisation in non-cystic fibrosis bronchiectasis patients.
Stockton Heath and Lymm Physiotherapy Practice, Respiratory Medicine, Stockton Heath Warrington, UK. fee@kellett.plus.com
Fiona
F
Kellett
Niven M
NM
Robert
D001987:Bronchiectasis / Q000503:physiopathology* / Q000628:therapy; D018592:Cross-Over Studies; D005100:Expectorants / Q000627:therapeutic use*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D009079:Mucociliary Clearance / Q000187:drug effects*; D009330:Nebulizers and Vaporizers; D011788:Quality of Life; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D013183:Sputum / Q000187:drug effects*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014797:Vital Capacity
D005100:Expectorants; D012462:Saline Solution, Hypertonic