Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Ludwig Engel Centre for Respiratory Research, Westmead Hospital, Sydney, New South Wales, Australia.
Thorax. 2016 Feb;71(2):141-7. doi: 10.1136/thoraxjnl-2014-206716.
The mucoactive effects of hypertonic saline should promote exacerbation resolution in people with cystic fibrosis (CF).
To determine the effects of hypertonic saline inhalation during hospitalisation for exacerbation of CF on length of stay, lung function, symptoms, oxygenation, exercise tolerance, quality of life, bacterial load and time to next hospitalisation.
132 adults with an exacerbation of CF were randomised to inhale three nebulised doses a day of either 4 mL 7% saline or a taste-masked control of 0.12% saline, throughout the hospital admission. The primary outcome measure was length of hospital stay.
All participants tolerated their allocated saline solution. There was no significant difference in length of stay, which was 12 days in the hypertonic saline group and 13 days in controls, with a mean between-group difference (MD) of 1 day (95% CI 0 to 2). The likelihood of regaining pre-exacerbation FEV1 by discharge was significantly higher in the hypertonic saline group (75% vs 57%), and the number needed to treat was 6 (95% CI 3 to 65). On a 0-100 scale, the hypertonic saline group had significantly greater reduction in symptom severity than the control group at discharge in sleep (MD=13, 95% CI 4 to 23), congestion (MD=10, 95% CI 3 to 18) and dyspnoea (MD=8, 95% CI 1 to 16). No significant difference in time to next hospitalisation for a pulmonary exacerbation was detected between groups (HR=0.86 (CI 0.57 to 1.30), p=0.13). Other outcomes did not significantly differ.
Addition of hypertonic saline to the management of a CF exacerbation did not reduce the length of hospital stay. Hypertonic saline speeds the resolution of exacerbation symptoms and allows patients to leave hospital with greater symptom resolution.
ACTRN12605000780651.
高渗盐水的粘液促排作用应该能促进囊性纤维化（CF）患者的恶化缓解。
确定 CF 恶化住院期间吸入高渗盐水对住院时间、肺功能、症状、氧合、运动耐量、生活质量、细菌负荷和下次住院时间的影响。
132 名 CF 恶化患者被随机分配，每天吸入 3 次 4 毫升 7%盐水或味道掩蔽的 0.12%盐水，整个住院期间。主要结局测量是住院时间。
所有参与者都耐受了他们分配的盐水溶液。住院时间没有显著差异，高渗盐水组为 12 天，对照组为 13 天，组间平均差异（MD）为 1 天（95%CI 0 至 2）。高渗盐水组出院时恢复恶化前 FEV1 的可能性明显更高（75% vs 57%），需要治疗的人数为 6（95%CI 3 至 65）。在 0-100 分制上，高渗盐水组在出院时的睡眠（MD=13，95%CI 4 至 23）、充血（MD=10，95%CI 3 至 18）和呼吸困难（MD=8，95%CI 1 至 16）方面的症状严重程度比对照组有显著改善。两组之间的下一次因肺部恶化而住院的时间没有显著差异（HR=0.86（CI 0.57 至 1.30），p=0.13）。其他结果没有显著差异。
在 CF 恶化的治疗中添加高渗盐水并没有减少住院时间。高渗盐水能加速恶化症状的缓解，使患者出院时症状得到更大程度的缓解。
ACTRN12605000780651。
