Effects of hypertonic saline on sputum clearance in patients with bronchiectasis

Hypertonic saline(HS)has been largely approved in cystic fibrosis to increase airway clearance while little evidence is available in bronchiectasis (BE) Aim: To compare 3 inhaled solutions(7%HS;0.1%Hialuronic Acid[HA]+7%HS and 0.9%Isotonic Saline[IS])in terms of:expectoration,cough severity,lung function and safety Methods: Was conducted a double-blind,randomized,crossover trial in BE patients.Patients inhaled each solution during 4 consecutive days,followed by a physiotherapy session(apart from 3rd day).A 7day washout period was used between treatments.Safety was analyzed using a adverse events9 score.In each treatment arm,lung function and cough severity(Leicester questionnaire,LCQ)were measured.For statistical analysis a mixed model was used(significant p Results: 24 patients were included with a mean age of 62.6(17.6[SD]).HS was the worst tolerated solution.HS and HA+HS induced greater expectoration during inhalation than IS([HSvsIS]9.9gvs3.9g(p rd day without physiotherapy.No differences were observed in 24h post-session sputum collection(p≥0.05)for days 1,2 and 4 while it was higher for day 3(15.9 vs 21.9,p Conclusions: This is the first study demonstrating that HA+HS and HS are more effective on sputum clearance than IS,being HA+HS better tolerated than HS.The combination HA+HS and physiotherapy was even more effective in reducing daily expectoration.