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Nebulised hypertonic saline for cystic fibrosis
1Department of Respiratory Medicine, John Hunter Hospital, Locked Bag No. 1, Hunter Regional Mail Centre, Newcastle, NSW 2310, Australia, 2310. pwark@ozemail.com.au
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Nebulized hypertonic saline (NHS) improves mucociliary clearance in cystic fibrosis patients. However, more research is needed to confirm its long-term benefits on lung function and quality of life.
Area of Science:
- Pulmonary Medicine
- Respiratory Diseases
- Pharmacology
Background:
- Cystic fibrosis lung disease involves impaired mucociliary clearance, recurrent infections, and airway inflammation.
- Hypertonic saline (HS) has demonstrated in-vitro potential to enhance mucociliary clearance, possibly mitigating airway inflammation.
Purpose of the Study:
- To evaluate the efficacy of nebulized hypertonic saline in improving lung function, exercise tolerance, quality of life, and reducing respiratory infection exacerbations in cystic fibrosis patients.
Main Methods:
- Systematic review of controlled trials comparing hypertonic saline to placebo or other mucolytic therapies in cystic fibrosis patients of all ages and disease severities.
- Searches included the Cochrane Cystic Fibrosis and Genetic Disorders Group trials register and conference abstracts.
- Data collection and quality assessment were performed independently by two reviewers.
Main Results:
- Seven trials involving 143 subjects were included, with study durations up to three weeks.
- Hypertonic saline significantly improved subjective chest clearance and mucociliary clearance rates (isotope clearance).
- One study showed a significant improvement in FEV1 (forced expiratory volume in 1 second) at two weeks with hypertonic saline compared to isotonic saline.
Conclusions:
- Nebulized hypertonic saline demonstrates immediate benefits for mucociliary clearance in cystic fibrosis.
- Current evidence, primarily from short-term studies on mild to moderate disease, is insufficient to recommend routine use.
- Further long-term studies are required to assess effects on pulmonary function, quality of life, and exacerbation frequency, and to compare with other therapies like nebulized deoxyribonuclease.