245 Audit of accepted hypertonic saline concentration in children with cystic fibrosis

Abstract

Background: Inhalation of hypertonic saline 6% (HS) improves mucociliary transport on short time basis in CF patients and is also proven to be a safe and low cost intervention. Autogenic Drainage (AD) is an effective airway clearance technique, experienced as very comfortable by CF patients. The aim of this study is to evaluate the efficacy of an AD treatment combined with inhalation of HS. It will also be examined if it is more efficient to inhale the HS before or during the AD session, and if the interventions are safe and comfortable. Methods: In this randomized, clinical cross-over study, 12 hospitalised CF patients >14yrs of age, received 3 therapy regimens in 3 consecutive days: inhalation of HS (4ml of NaCl 6%) during AD (30min), inhalation of HS (4ml of NaCl 6%) before AD (HS pre AD), and AD only (30min). Before and after each session, oxygen saturation (SaO2), heart frequency (HF) and dyspnoea were measured and wet sputum was collected and weighed. Results: Patients significantly coughed up more sputum during treatments where AD was combined with HS (“AD+HS” and “HS pre AD”) compared to the AD treatment without HS (respectively 20.4±9.6 and 20.6± vs. 15.2±9.3 g; respectively p = 0.01 and p = 0.028). There was no significant difference in wet sputum weight between “HS+AD” and “HS pre AD” (p = 0.942). For SaO2, HF and dyspnoea, no significant differences were found before and after treatments. Conclusion: By inhaling HS during AD, the duration of treatment can be shortened and the compliance improved without a loss of efficiency in sputum clearance. This intervention has proven to be safe and comfortable.