Written by Tatjana Djakovic, Staff Writer. Double-blind, parallel-group study shows hypertonic saline improved the vital capacity of cystic fibrosis patients by 81 %.
The life expectancy of cystic fibrosis patients has dramatically improved since the 1950’s, however there is still no cure and the lifetime health care costs in the U.S. are approximately $306,332 (1). Cystic fibrosis is caused by a mutation in the gene which results in abnormal transport of ions across the membranes of the respiratory system. There is an excessive loss of salt from the lungs and respiratory airways, which carries water with it and dehydrates airways and results in thick mucus secretions. The thick mucus secretion makes breathing more difficult and enables an environment in which bacteria can thrive and cause infections that can lead to irreversible lung damage (2).
The purpose of the current study is to see if administrating water enriched with a high concentration of salt will help draw water back in to the lungs and decrease the thick mucus layer. In this double-blind, parallel-group study, researchers administered hypertonic saline or an extra-salty sterile water in mist form in order to help clear the thick mucus from the lungs. The study included 164 patients with stable cystic fibrosis who were at least six years old who inhaled 4 ml of either 7% salt water or 0.9% salt water (control) twice daily for 48 weeks (3).
There were significant improvements in lung function in the group that received highly concentrated salt water inhalation treatments. In addition, the vital capacity (the maximum amount of air a person can expel from the lungs after a maximum inhalation) improved by 81% (p=0.004) in those participants that were younger than 18 years of age (3).
| Improvement by using Hypertonic solution | P-value | |
| FEV1(maximum amount of air exhaled in one second) | 68 ml higher than control | P=0.004 |
| FVC(amount of air which can be forcibly exhaled from the lungs after taking the deepest breath ) | 82 ml higher than control | P=0.004 |
| Number of days with symptoms during trial | 68.1% less than control | P<0.001 |
| Number of days absent from school or work | 70.8% less than control | P<0.001 |
| Percentage of participants remaining symptoms free | 25% more participants symptom free compared to control | P<0.001 |
The study showed that adding salt (and water) to the airway surface of patients with cystic fibrosis is beneficial because it improves lung function and reduces the amount of events that deteriorate lung function and also reduce the amount of days absent from school and work. Hypertonic saline is currently recommended by the Cystic Fibrosis Foundation as a primary part of a cystic fibrosis treatment regiment.
Source: Elkins, Mark R., et al. “A controlled trial of long-term inhaled hypertonic saline in patients with cystic fibrosis.” New England Journal of Medicine 354.3 (2006): 229-240.
Copyright © 2017 Massachusetts Medical Society. All rights reserved.
Posted January 23, 2014.
References:
- Delatycki, M., et al. “Understanding the costs of care for cystic fibrosis: an analysis by age and health state.” (2013).
- Jaffe, A., and A. Bush. “Cystic fibrosis: review of the decade.” Monaldi archives for chest disease. 56.3 (2001): 240.
- Elkins, Mark R., et al. “A controlled trial of long-term inhaled hypertonic saline in patients with cystic fibrosis.” New England Journal of Medicine 354.3 (2006): 229-240.
