Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1997 Oct;52(10):900–903. doi: 10.1136/thx.52.10.900

Effect of increasing doses of hypertonic saline on mucociliary clearance in patients with cystic fibrosis

M Robinson, A L Hemming, J A Regnis, A G Wong, D L Bailey, G J Bautovich, M King, P T Bye
PMCID: PMC1758438  PMID: 9404379

Abstract

BACKGROUND: Patients with cystic fibrosis are known to have decreased mucociliary clearance. It has previously been shown that inhalation of a 7.0% solution of hypertonic saline significantly improved mucociliary clearance in a group of adult patients with cystic fibrosis. The aim of this study was to measure the response to increasing concentrations of inhaled hypertonic saline. METHODS: Ten patients (seven men) of mean (SE) age 22 (4) years and mean forced expiratory volume in one second (FEV1) 52.0 (6.7)% predicted completed the study. Mucociliary clearance was measured using a radioaerosol technique for 90 minutes after the interventions which comprised 0.9% NaCl + voluntary cough (control), 3.0% NaCl, 7.0% NaCl, and 12% NaCl. RESULTS: There was a significant increase in the amount of activity cleared from the right lung with all concentrations of hypertonic saline (HS) compared with control. The amount cleared at 90 minutes on the control day was 12.7% (95% confidence interval (CI) 9.8 to 17.2) compared with 19.7% (95% CI 13.6 to 29.5) for 3% HS, 23.8% (95% CI 15.9 to 36.7) for 7% HS and 26.0% (95% CI 19.8 to 35.9) for 12% HS. The improvement in mucociliary clearance was not solely due to coughing as the number of coughs recorded on the control day exceeded that recorded on any other day. The hypertonic saline did not induce a clinically significant change in FEV1. CONCLUSIONS: Within the range of concentrations examined in this study, the effect of hypertonic saline appears to be dose dependent. Inhalation of hypertonic saline remains a potentially useful treatment for patients with cystic fibrosis. 




Full Text

The Full Text of this article is available as a PDF (130.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Assouline G., Leibson V., Danon A. Stimulation of prostaglandin output from rat stomach by hypertonic solutions. Eur J Pharmacol. 1977 Aug 1;44(3):271–273. doi: 10.1016/0014-2999(77)90073-5. [DOI] [PubMed] [Google Scholar]
  2. Bailey D. L., Fulton R. R., Jackson C. B., Hutton B. F., Morris J. G. Dynamic geometric mean studies using a single headed rotating gamma camera. J Nucl Med. 1989 Nov;30(11):1865–1869. [PubMed] [Google Scholar]
  3. Bailey D. L., Robinson M., Meikle S. R., Bye P. T. Simultaneous emission and transmission measurements as an adjunct to dynamic planar gamma camera studies. Eur J Nucl Med. 1996 Mar;23(3):326–331. doi: 10.1007/BF00837632. [DOI] [PubMed] [Google Scholar]
  4. Bennett W. D., Foster W. M., Chapman W. F. Cough-enhanced mucus clearance in the normal lung. J Appl Physiol (1985) 1990 Nov;69(5):1670–1675. doi: 10.1152/jappl.1990.69.5.1670. [DOI] [PubMed] [Google Scholar]
  5. Daviskas E., Anderson S. D., Gonda I., Eberl S., Meikle S., Seale J. P., Bautovich G. Inhalation of hypertonic saline aerosol enhances mucociliary clearance in asthmatic and healthy subjects. Eur Respir J. 1996 Apr;9(4):725–732. doi: 10.1183/09031936.96.09040725. [DOI] [PubMed] [Google Scholar]
  6. Eng P. A., Morton J., Douglass J. A., Riedler J., Wilson J., Robertson C. F. Short-term efficacy of ultrasonically nebulized hypertonic saline in cystic fibrosis. Pediatr Pulmonol. 1996 Feb;21(2):77–83. doi: 10.1002/(SICI)1099-0496(199602)21:2<77::AID-PPUL3>3.0.CO;2-M. [DOI] [PubMed] [Google Scholar]
  7. Folkesson H. G., Kheradmand F., Matthay M. A. The effect of salt water on alveolar epithelial barrier function. Am J Respir Crit Care Med. 1994 Dec;150(6 Pt 1):1555–1563. doi: 10.1164/ajrccm.150.6.7952614. [DOI] [PubMed] [Google Scholar]
  8. Goldman M. J., Anderson G. M., Stolzenberg E. D., Kari U. P., Zasloff M., Wilson J. M. Human beta-defensin-1 is a salt-sensitive antibiotic in lung that is inactivated in cystic fibrosis. Cell. 1997 Feb 21;88(4):553–560. doi: 10.1016/s0092-8674(00)81895-4. [DOI] [PubMed] [Google Scholar]
  9. Joris L., Dab I., Quinton P. M. Elemental composition of human airway surface fluid in healthy and diseased airways. Am Rev Respir Dis. 1993 Dec;148(6 Pt 1):1633–1637. doi: 10.1164/ajrccm/148.6_Pt_1.1633. [DOI] [PubMed] [Google Scholar]
  10. Regnis J. A., Robinson M., Bailey D. L., Cook P., Hooper P., Chan H. K., Gonda I., Bautovich G., Bye P. T. Mucociliary clearance in patients with cystic fibrosis and in normal subjects. Am J Respir Crit Care Med. 1994 Jul;150(1):66–71. doi: 10.1164/ajrccm.150.1.8025774. [DOI] [PubMed] [Google Scholar]
  11. Robinson M., Regnis J. A., Bailey D. L., King M., Bautovich G. J., Bye P. T. Effect of hypertonic saline, amiloride, and cough on mucociliary clearance in patients with cystic fibrosis. Am J Respir Crit Care Med. 1996 May;153(5):1503–1509. doi: 10.1164/ajrccm.153.5.8630593. [DOI] [PubMed] [Google Scholar]
  12. Rodwell L. T., Anderson S. D. Airway responsiveness to hyperosmolar saline challenge in cystic fibrosis: a pilot study. Pediatr Pulmonol. 1996 May;21(5):282–289. doi: 10.1002/(SICI)1099-0496(199605)21:5<282::AID-PPUL3>3.0.CO;2-P. [DOI] [PubMed] [Google Scholar]
  13. Smith J. J., Travis S. M., Greenberg E. P., Welsh M. J. Cystic fibrosis airway epithelia fail to kill bacteria because of abnormal airway surface fluid. Cell. 1996 Apr 19;85(2):229–236. doi: 10.1016/s0092-8674(00)81099-5. [DOI] [PubMed] [Google Scholar]
  14. Wills P. J., Hall R. L., Chan W., Cole P. J. Sodium chloride increases the ciliary transportability of cystic fibrosis and bronchiectasis sputum on the mucus-depleted bovine trachea. J Clin Invest. 1997 Jan 1;99(1):9–13. doi: 10.1172/JCI119138. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES