Hypertonic saline is a therapeutic course recommended for patients who suffer from cystic fibrosis (CF). The therapy is included in the group of mucolytic medications for cystic fibrosis and other respiratory diseases and conditions. Hypertonic saline is extra salty water that is sterilized so it is germ-free. Patients are often prescribed the inhalation of hypertonic saline mist twice a day in order to improve airway clearance and lung function.
Cystic fibrosis is a chronic, inherited condition characterized by the formation and accumulation of thick and sticky mucus in the lungs, which causes coughing and difficulties in breathing. These symptoms are associated with a lack of enough salt and water in the airways affected by cystic fibrosis, which is why a hypertonic saline mist acts as a mucolytic and is able to thin mucus and promote airway clearance.
History of Hypertonic Saline
The use of hypertonic saline was studied in a Phase 3 trial conducted in Australia, which revealed the benefits of the treatment in the pulmonary health of cystic fibrosis patients. In 2008, it became clear that hypertonic saline was beneficial and safe in CF patients and become a widely used therapy.
Since there is no need for a prescription, there are people who think they can make their own hypertonic saline solution due to its simple composition. However, the Cystic Fibrosis Foundation (CF Foundation) notes that patients and caregivers need to consider the risk of germs getting into the lungs through tainted hypertonic saline, as well as the fact that specific levels of salt in the solution are different depending on the patient. This is why the foundation recommends patients obtain a hypertonic saline prepared by a pharmacy and recommended by their healthcare team or pharmacist.
How Hypertonic Saline Works
“The lung disease in cystic fibrosis is characterized by impaired mucociliary clearance, recurrent bronchial infection and airway inflammation. Hypertonic saline has been shown to enhance mucociliary clearance in vitro and this may act to lessen the destructive inflammatory process in the airways,” write the authors of the study “Nebulised hypertonic saline for cystic fibrosis.”
Not only has hypertonic saline been proven to act against airway mucus in cystic fibrosis, help aid mucociliary clearance, and restore the liquid layer that lines the airways, it has also been shown to have anti-infective and anti-inflammatory properties. As a result, hypertonic saline is used by about 14,000 patients in the United States who suffer from cystic fibrosis, according to the CF Foundation. Its use among children has not yet been confirmed safe and beneficial. However, a Phase 2 trial of hypertonic saline in preschool children is currently underway.
Other Details About Hypertonic Saline
Hypertonic saline is usually administered the first time while the patient is at a care center to ensure that it is well tolerated. Some side effects may include increased coughing, sore throat, and chest tightness, which are related to irritation of the airways.
“We do not know if hypertonic saline is safe for everyone. We do know that people who are 6 years of age and older, or who have an FEV1 [forced expiratory volume in one second] greater than or equal to 40 percent predicted might be able to take hypertonic saline,” the CF Foundation explains on its website. “Before it can be prescribed, your CF care team can provide you with more information and may do some tests (sputum cultures) to see if hypertonic saline is right for you or your child.”
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