Effect of hypertonic saline, amiloride, and cough on mucociliary clearance in patients with cystic fibrosis

Am J Respir Crit Care Med. 1996 May;153(5):1503-9. doi: 10.1164/ajrccm.153.5.8630593.

Abstract

In patients with cystic fibrosis (CF), dehydration of airway secretions leads to a decrease in mucociliary clearance (MCC). We examined the acute effect of MCC of a single administration by aerosolization of hypertonic saline (7%) (HS), amiloride (0.3% in 0.12% NaCl) (AML) and a combination of AML and HS (AML + HS) in 12 patients with CF using a radioaerosol technique. Isotonic saline [0.9%] (IS) was used as a control solution. As both the AML and HS solutions induced cough in some patients, the last nine patients studied also underwent a cough clearance day. This was to eliminate the possible confounding effect of cough on MCC measurement. Patients ranged from 18 to 28 yr (mean +/- SD, 22 +/- 3) with an FEV1 of 27 to 112% predicted (61 +/- 30%). Following deposition of the radioaerosol, baseline clearance was assessed for 30 min. This was followed by a 30-min intervention period. Assessment of post-intervention clearance for a further 30 min was then performed. Comparison of the amount of radioaerosol cleared from the right lung was made at 60 min (%C60) and 90 min (%C90) using repeated measures ANOVA. The percent cleared at 60 and 90 min was significantly increased with HS (%C60 = 26.5%, %C90 = 29.4%) and the combination of AML + HS (%C60 = 23.1%, %C90 = 27.4%) compared with both IS (%C60 = 14.7%, %C90 = 17.5%) and COUGH (%C60 = 18.0%, %C90 = 19.5%), p < 0.01. Inhalation of hypertonic saline is a potentially useful treatment in patients with cystic fibrosis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aerosols
  • Amiloride / administration & dosage
  • Amiloride / therapeutic use*
  • Analysis of Variance
  • Confounding Factors, Epidemiologic
  • Cough / chemically induced
  • Cough / physiopathology*
  • Cystic Fibrosis / physiopathology*
  • Cystic Fibrosis / therapy
  • Drug Combinations
  • Expectorants / administration & dosage
  • Expectorants / therapeutic use*
  • Female
  • Forced Expiratory Volume / drug effects
  • Humans
  • Isotonic Solutions
  • Lung / drug effects
  • Lung / physiopathology
  • Male
  • Mucociliary Clearance / drug effects*
  • Saline Solution, Hypertonic / administration & dosage
  • Saline Solution, Hypertonic / therapeutic use*
  • Technetium Tc 99m Sulfur Colloid

Substances

  • Aerosols
  • Drug Combinations
  • Expectorants
  • Isotonic Solutions
  • Saline Solution, Hypertonic
  • Technetium Tc 99m Sulfur Colloid
  • Amiloride