The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts

THE EFFICACY OF 7% HYPERTONIC SALINE IN PATIENTS WITH CYSTIC FIBROSIS: A RETROSPECTIVE STUDY

Sandra Kindel1,2



Background: Cystic fibrosis (CF) is a genetic disorder of the exocrine system that affects approximately 20,000 people in the US. It is a disease with death typically resulting from respiratory failure and/or pneumonia after years of chronic pulmonary infections. These chronic infections are caused by the tenacious secretions in the lungs of CF patients. Patients receive daily chest physiotherapy and nebulized medications to help prevent these infections. Dornase Alfa (rhDnAse) is a genetically designed medication used to break down the viscous bonds of infectious secretions in the CF lung. For the past couple of years 7% Hypertonic Saline (HTS) has been introduced into the regime of the CF patient. HTS is thought to increase mucociliary action by replacing the chloride in the aqueous lining of the lungs, aiding the patient with secretion clearance and reducing the number of exacerbations and admissions.

Methods:
Data consisting of 70 admissions of 29 unique CF patients was collected from May 2007 through May 2008. Exclusion criteria are: death, cepacia, less than one year treatment at this CF center, admissions for pneumothorax or intubation caused by respiratory failure. The collected data consists of: clinical days, pulmonary function test (PFT) baseline and the % PFT increase during hospitalization. The PFT used was the forced expiratory volume in one second (FEV1). To obtain the baseline, three FEV1s were averaged, excluding PFTs performed within 2 weeks of hospital admission or discharge. Patients were placed into one of four groups: (1) solely HTS, (2) solely rhDnAse, (3) both HTS and rhDnAse and (4) those who do neither.

Results:
Group 3: those patients using HTS and rhDnAse had the most admissions (48 out of 70). There was no significant difference in the admission rates between the four groups. Patients receiving only HTS experienced the most improvement in FEV1 and the length of stay was slightly higher for this group.

Conclusion:
7% hypertonic saline is a viable addition to the treatment of cystic fibrosis and has the potential to improve the activities of daily living for these patients. Data is preliminary and will continue to be collected on patients with only rhDnAse and/or HTS to better assess outcomes.