Study design (if review, criteria of inclusion for studies)
Randomised crossover trial
Participants
24 patients with bronchiectasis
Interventions
Patients were randomised to receive four single treatment schedules in random order: (1) active cycle breathing technique (ACBT) alone, (2) nebulised terbutaline then ACBT, (3) nebulised terbutaline, nebulised IS then ACBT and (4) nebulised terbutaline, nebulised HS then ACBT.
Outcome measures
Sputum weight; ease of expectoration; sputum viscosity; FEV1
Main results
Sputum weights were significantly higher after HS than IS (P = 0.002). Ease of expectoration also differed overall (P < 0.0001) and was significantly lower with HS than with IS (P = 0.0005). Sputum viscosity differed between treatment phases, with a significant linear trend to reduced sputum viscosity with HS (P = 0.0002). These changes were associated with small but statistically significant differences in FEV1 (P = 0.043) and FVC (P = 0.011) between treatment phases.
Authors' conclusions
Nebulised hypertonic saline can be used safely and effectively as an adjunct to physiotherapy in selected patients. A long-term prospective trial is now indicated to determine its effectiveness on long-term infection rate, quality of life and lung function.
Keywords: hydration; Hypertonic Solutions; Inhalation OR nebulised; pharmacological_intervention; Airway clearance drugs -expectorants- mucolytic- mucociliary-; Airway clearance technique; non pharmacological intervention - devices OR physiotherapy; Respiratory System Agents; Chest physiotherapy; Active Cycle of Breathing Technique -ACBT-; Adrenergic beta-Agonists; nebuliser; Terbutaline; Bronchiectasis; Respiratory Tract Diseases;