Inhalation with high-dosage saline

Question

Dear expert team,
at a talk in the year 2000 high-dosage saline (6%-solution) was dehorted absolutely in case of pseudmonas-free lungs - is that still the case?
Best regards

Answer

Dear questioner,
since 2000, important clinical studies have been presented on the efficacy of the inhalation of hypertonic saline (5-6% NaCl) in patients with CF. Those show an overall good tolerance with also a clinically relevant effect. A danger for Pseudomonas aeruginosa positive or negative CF-patients is thereby nowhere described.
The discussion in 2000 was probably about the question, how the "Epithelial lining fluid" of the airways (that is the fluid film, which covers all airways and has a great importance for the cleaning et al.) is composed concerning the concentration of NaCl. This discussion is not relevant anymore. The former recommendations did not get a support from corresponding data. Also the intermittent discussion about antimicroibial peptides (small substances of the body with an antibiotic effect) and its changing of activity dependent on the local NaCl-concentration has come to rest. The salt-concentration depenent peptides have overall only a very small part in the local infection defence of the lung. In summary, one can regard the inhalation of hypertonic saline as an established element of the therapy. It is howver a therapy, which has to be prescribed and controlled by a physician, as all other therapies, too.
I hope to have helped you furhter with the information
PD Dr. Ballmann

12.06.2009