A randomised trial of hypertonic saline during hospitalisation for exacerbation of cystic fibrosis
| Autor: | Mark R. Elkins, Peter A. B. Wark, Honghua Hu, Christopher J. Harmer, Peter G. Middleton, Ruth Dentice, Peter T. P. Bye, Jennifer Bishop, Douglas J. Dorahy |
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| Rok vydání: | 2016 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Exacerbation Adolescent Cystic Fibrosis medicine.medical_treatment Cystic fibrosis Drug Administration Schedule Article 03 medical and health sciences Young Adult 0302 clinical medicine Quality of life Forced Expiratory Volume Administration Inhalation Medicine Humans 030212 general & internal medicine Prospective Studies Saline Saline Solution Hypertonic Inhalation business.industry Respiratory infection Length of Stay Middle Aged medicine.disease Surgery Hypertonic saline Hospitalization Treatment Outcome 030228 respiratory system Anesthesia Number needed to treat Quality of Life Patient Compliance Female business Follow-Up Studies |
| Zdroj: | Thorax. 71(2) |
| ISSN: | 1468-3296 |
| Popis: | Background The mucoactive effects of hypertonic saline should promote exacerbation resolution in people with cystic fibrosis (CF). Objectives 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. Methods 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. Results 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 FEV 1 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. Conclusions 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. Trial registration number ACTRN12605000780651. |
| Databáze: | OpenAIRE |
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