Jan, 2001. Saline [online]. Seacroft and St James's University Hospitals, Leeds, UK. Available from http://www.cysticfibrosismedicine.com

Two to four ml of normal saline are nebulised twice daily before physiotherapy to loosen the sputum in some patients. In practice, when saline is given before physiotherapy it is usually combined with a bronchodilator, e.g., salbutamol or terbutaline. There is recent interest in the use of nebulised hypertonic (7.5% or 9%) saline which stimulates mucus secretion and augments sputum volume. Studies have shown a significant improvement in mucociliary clearance (Robinson et al, 1996, Robinson et al, 1997). Engl demonstrated a 12.3% improvement in FEV1 compared to controls when nebulised 6% saline was used (Engl et al, 1996). Hypertonic saline and rhDNase had a similar effect on sputum clearance and respiratory function in 14 patients with CF who took either 5.85% saline or 2.5 mg rhDNase twice daily (Ballman & von der Hardt, 1998).

References

Ballman M, von der Hardt H. Hypertonic saline and recombinant human DNase: a randomised crossover pilot study in patients with cystic fibrosis. 22nd European CF Congress, Berlin, 1998. PS1-7

Engl PA, Morton J, Douglas J, Riedler J, Wilson J, Robertson C. Short term efficacy of ultrasonically nebulised hypertonic saline with cystic fibrosis Pediatr Pulmonol 1996; 21: 77-83.

Robinson M, Regnis JA, Bailey DL, King M, Bautovich GJ, Bye PT et al. Effect of hypertonic saline, amiloride, and cough on mucociliary clearance in patients with cystic fibrosis. Am J Resp Crit Care Med 1996; 153: 1503-1509

Robinson M, Hemming AL, Regnis JA , Wang AG, Bailey DL, Bautovich GJ et al. Effect of increasing doses of hypertonic saline on mucociliary clearance in patients with cystic fibrosis. Thorax 1997; 52: 900-903

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