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P104 Nebulised hypertonic saline improves quality of life in adult patients with non-cystic fibrosis bronchiectasis
  1. K Bentley,
  2. ZL Borrill
  1. North Manchester General Hospital, Manchester, UK

Abstract

Background Nebulised hypertonic saline (HTS) improved lung function, quality of life and exacerbation frequency in a study of patients with non-cystic fibrosis (CF) bronchiectasis1. It may improve chest clearance by increasing water content of airway surface liquid, enhancing mucociliary clearance. A protocol was developed for the use of HTS in a district hospital setting. Safety, tolerability, lung function and quality of life data are presented.

Methods Patients with non-CF bronchiectasis were assessed on a locally developed chest clearance pathway consisting of active cycle breathing technique, postural drainage, flutter device and mucolytic. Patients with ongoing symptoms were given a trial dose of 4 mls HTS 7% with spirometry measured pre and post. Patients continued on 4 mls HTS od/bd for 12 months if tolerated. Adverse effects, quality of life and spirometry was collected at 4 weeks and 6 months. Data were compared using paired t tests.

Results 34 patients (mean age 62, 25 female, mean FEV1 66% predicted) were assessed. 2 (6%) patients did not proceed with treatment due to (a. FEV1 decline >15% and b. severe nausea). 9 (26%) patients experienced mild side effects. FEV1 improved significantly at 4 weeks (1.53 vs 1.41 p = 0.01). Leicester Cough Questionnaire improved significantly at 4 weeks (mean total score 13.7 vs 11.8 p = 0.0003) with a mean difference in LCQ of 1.9 (minimum clinically important difference MCID > 1.32). St Georges Respiratory Questionnaire improved significantly at 6 months (mean total score 56.1 vs 67.8 p = 0.01) with a mean difference of 11% (MCID > 4%3).

Abstract P104 Table 1.

Changes in LCQ and SGRQ scores.

Conclusions In this uncontrolled study, HTS was well tolerated and resulted in improved lung function and quality of life in patients with non-CF bronchiectasis.

References

  1. Kellett F Niven RM. Nebulised 7% hypertonic saline improves lung function and quality of life in bronchiectasis. Respiratory Medicine 2011; 105: 1831–1835.

  2. Raj AA et al. Clinical cough IV: what is the minimally important difference for the Leicester Cough Questionnaire? Handb Exp Pharmacol 2009; 187: 311–320.

  3. Jones PW. Interpreting thresholds for a clinically significant change in health status in asthma and COPD. Eur Respir J. 2002; 19: 398–404.

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