Article Text

PDF

Clinical challenges in diagnosing and managing respiratory infection
P239 Audit of once daily nebulised hypertonic 6% saline (HTS) in adult non-CF bronchiectasis
  1. H Pyne,
  2. B Kane,
  3. B R O'Driscoll
  1. Salford Royal Foundation hospital Trust, Salford, UK

Abstract

Background Nebulised hypertonic 7% saline enhances sputum clearance in patients with bronchiectasis and hypersecretion (Kellet F et al Med 2005; 99:27–31) but is not licensed for this purpose. It is expensive to produce, has a short shelf life and is difficult to administer. Mucoclear® 6% saline does not have these disadvantages so we wished to evaluate its clinical benefits.

Method Patients with troublesome bronchiectasis were invited for a nebulised 6% HTS challenge. If no adverse reaction occurred, they administered HTS daily for 2 months

Results 60 patients were assessed over 18 months. Ten had bronchospasm after HTS, 9 did not wish to continue treatment and 41 reported an initial positive response and administered HTS once daily for 2 months. All 41 patients reported improved ease of sputum clearance with a median 3 point increase on a 10 unit Viausal Analogue Scale. 49% reported increase in sputum volume. 10 patients had baseline oxygen saturation ≤95% with ≥2% rise on HTS. 59% reported an increase in quality of life on Juniper mini asthma quality of life questionnaire (mean 0.6 unit rise overall and 1.0 for responders; rise of >0.5 units is significant). Mean FEV1 rose 9.5% (from 1.68 to 1.84 litres) and mean FVC rose 10.5% (from 2.48 to 2.74 litres). (Wilcoxon test p<0.001). There was no change in spirometry for seven patients with normal baseline measurements but FEV1 rose by 13% and FVC rose by 12% among 34 patients with abnormal lung function. All patients reported a noticeable improvement in their condition (12% reported “life changing improvement”).

Conclusion Despite standard therapies some adults with bronchiectasis have persistent troublesome hypersecretion. Two thirds of our patients reported a significant improvement in symptoms using HTS and, for some, this was life changing. This suggests that Mucoclear® 6% hypertonic nebulised saline is a viable option but controlled trials are needed.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.