You are here

Article Text

Article menu

Download PDFPDF

Cystic fibrosis
Original article
A randomised trial of hypertonic saline during hospitalisation for exacerbation of cystic fibrosis
Free
  1. Ruth L Dentice1,2,
  2. Mark R Elkins1,2,
  3. Peter G Middleton3,
  4. Jennifer R Bishop3,
  5. Peter A B Wark4,
  6. Douglas J Dorahy4,
  7. Christopher J Harmer2,
  8. Honghua Hu2,5,
  9. Peter T P Bye1,2
  1. 1Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
  2. 2Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
  3. 3Ludwig Engel Centre for Respiratory Research, Westmead Hospital, Sydney, New South Wales, Australia
  4. 4Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute, University of Newcastle and John Hunter Hospital, Newcastle, New South Wales, Australia
  5. 5Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
  1. Correspondence to Dr Ruth L Dentice, Department of Respiratory Medicine, Level 11 E Block, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia; ruth.dentice{at}sswahs.nsw.gov.au

Abstract

Background The mucoactive effects of hypertonic saline should promote exacerbation resolution in people with cystic fibrosis (CF).

Objectives To determine the effects of hypertonic saline inhalation during hospitalisation for exacerbation of CF on length of stay, lung function, symptoms, oxygenation, exercise tolerance, quality of life, bacterial load and time to next hospitalisation.

Methods 132 adults with an exacerbation of CF were randomised to inhale three nebulised doses a day of either 4 mL 7% saline or a taste-masked control of 0.12% saline, throughout the hospital admission. The primary outcome measure was length of hospital stay.

Results All participants tolerated their allocated saline solution. There was no significant difference in length of stay, which was 12 days in the hypertonic saline group and 13 days in controls, with a mean between-group difference (MD) of 1 day (95% CI 0 to 2). The likelihood of regaining pre-exacerbation FEV1 by discharge was significantly higher in the hypertonic saline group (75% vs 57%), and the number needed to treat was 6 (95% CI 3 to 65). On a 0–100 scale, the hypertonic saline group had significantly greater reduction in symptom severity than the control group at discharge in sleep (MD=13, 95% CI 4 to 23), congestion (MD=10, 95% CI 3 to 18) and dyspnoea (MD=8, 95% CI 1 to 16). No significant difference in time to next hospitalisation for a pulmonary exacerbation was detected between groups (HR=0.86 (CI 0.57 to 1.30), p=0.13). Other outcomes did not significantly differ.

Conclusions Addition of hypertonic saline to the management of a CF exacerbation did not reduce the length of hospital stay. Hypertonic saline speeds the resolution of exacerbation symptoms and allows patients to leave hospital with greater symptom resolution.

Trial registration number ACTRN12605000780651.

  • Cystic Fibrosis
  • Nebuliser therapy
  • Respiratory Infection

https://doi.org/10.1136/thoraxjnl-2014-206716

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.

    View Full Text

    Linked Articles