The efficacy and tolerability of inhaled hypertonic saline in children with cystic fibrosis

Abstract

Introduction: Cystic fibrosis (CF) is a multisystem disorder, caused by mutations in the CF gene and characterized by viscous secretions of the exocrine glands. The disruption of mucociliary clearance plays a basic role in the vicious cycle of airway obstruction, infection, inflammation and lung damage. Inhaled hypertonic saline (HS) represents a well-documented therapy in CF. But studies to date show that not all patients can tolerate HS due to local side effects. The aim is to study the efficacy and tolerability of treatment with inhaled HS of various concentrations in children with CF. Methods of research: 34 children with CF aged 6 to 18 years were examined. The study included three consecutive inhalations of sterile solution NaCl (0,9%, 3% and 7%) 2 minutes each. Spirometry was performed before and after each inhalation, clinical changes were analyzed. Results: The cough in patients became more productive and moist rales above the lungs were heard more often after inhalation of HS. The activity of secretion of induced sputum was identical while the tolerance of inhalation of 3% NaCl and 7% NaCl was different. The side effects such as sore throat, shortness of breath, cough and bronchospasm were recorded significantly more often after inhalation of 7% NaCl. Clinically significant decrease (more than 20%) in FEV1 was observed in 5.8% of patients after inhalation of 3% NaCl and in 11.8% of patients after inhalation of 7% NaCl, which correlated with appearance of wheezing above the lungs. Conclusions: Inhaled HS is effective mucolytic for patients with CF but requires determining the individual sensitivity of the patient before the treatment for positive therapeutic effect.