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Nebulised hypertonic saline for cystic fibrosis
1Level D, Centre Block, University Medicine, Southampton General Hospital, Southampton, UK, SO16 6YD. P.Wark@soton.ac.uk
The Cochrane Database of Systematic Reviews
|January 22, 2003
Summary
Nebulized hypertonic saline (HS) improves mucociliary clearance and lung function in cystic fibrosis patients short-term. However, it may be less effective than DNase for lung function after three months, with insufficient evidence for routine use.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Cystic Fibrosis (CF) lung disease involves impaired mucociliary clearance.
- Hypertonic saline (HS) shows potential to enhance mucociliary clearance and reduce airway inflammation.
Purpose of the Study:
- To evaluate nebulized hypertonic saline's effects in CF patients.
- Comparison against placebo and other mucociliary clearance-enhancing treatments.
Main Methods:
- Systematic review of controlled trials (any language, any duration/dose).
- Searched Cochrane Cystic Fibrosis and Genetic Disorders Group trials register (search updated October 2001).
- Included 235 participants across nine trials, aged 6-46 years.
Main Results:
- Short-term trials showed HS increased isotope clearance and improved lung function (FEV1) versus placebo.
- HS (3-7% saline, 10mls BID) significantly increased FEV1 (WMD 12.20).
- Compared to DNase, HS showed similar short-term FEV1 benefits but less benefit after 12 weeks in moderate-to-severe lung disease.
Conclusions:
- Nebulized HS enhances mucociliary clearance and lung function short-term.
- May be less effective than DNase for lung function after three months.
- Insufficient evidence currently supports routine HS use in CF patients.