Conflicting expert opinions

Question

Dear expert team,

does hypertonic saline solution only mobilize more mucus, or can its inhalation also have negative effects, i.e. promote mucus production?

There are two conflicting assessments of this in this forum:

"After all, with inhalation, one sometimes produces mucus that was not there before" (Prof. Dr. Joachim Bargon on the effect of hypertonic saline solution)

vs.

"Hypertonic saline solution helps mobilize existing mucus, i.e. makes it more liquid and thus easier removable. It does not produce new mucus." (PD Dr. Manfred Ballmann)

Which of the two is right? Even in the CF clinic people sometimes say the one and sometimes the other.

Kind regards

Answer

Hello,

practical experience shows that neither comment is wrong. Like with many inhaled drugs, every patient reacts a bit differently. This is true for inhaled antibiotics, for Pulmozyme® (dornase alfa) and also for hypertonic saline solution. And with the latter, it also depends on the concentration and the manufacturer. Some people do very well with it, mobilize their sputum because it becomes more liquid, and can cough it up better. Some others do not tolerate it, become tight or complain about more sputum, just like healthy people also do when inhaling hypertonic saline solution.

So try it yourself, and if it helps, then good -- if not, you can either try a different compound, or it is simply not the ideal thing for you.

Kind regards,
Prof. Jochen Bargon

11.12.2012