Experience of inhaled hypertonic saline use in pediatric pulmonology

Abstract

Impaired secretion and removal of mucus from the respiratory tract are important pathophysiological links in the development of several pulmonary pathologies: chronic obstructive pulmonary disease, bronchial asthma, bronchiectasis, cystic pulmonary fibrosis, etc. In the article, modern approaches to the use of inhaled hypertonic (3-7%) sodium chloride solutions in children with various recurrent and chronic bronchopulmonary pathologies are analysed. The combination of hypertonic sodium chloride solution and hyaluronic acid can minimize the unpleasant effects of hypertonic solution, such as irritating cough caused by the effect of salt on the cough receptors of the upper respiratory tract. At the same time, hyaluronic acid has unique water-retaining properties, therefore it plays an important role in regulating the fluid balance in the lung interstitium, moistens the airways, reduces bronchial hyperresponsiveness, decreases inflammation and destroys the biofilm associated with chronic infection. The use of nebulizer inhalations with a combination drug containing hypertonic sodium chloride solution and hyaluronic acid has proved to be successful in pulmonological pediatric practice. The authors have learned first-hand that this combination is highly efficient. The described clinical cases demonstrate the positive experience of inhaled use of the domestic combination drug of 3% hypertonic sodium chloride solution and hyaluronic acid in the treatment of preschool patients (5 years old) with the following diagnoses: recurrent bronchitis, primary ciliary dyskinesia (Kartagener's syndrome). This inhalation therapy helped not only to improve the rheological properties of sputum, quickly restore the bronchi to health, reduce signs of inflammation of the respiratory tract, but also generally improve the patients' breathing and quality of life.