A Controlled Trial of Long-Term Inhaled Hypertonic Saline in Patients with Cystic Fibrosis

Patients with cystic fibrosis have inspissated mucus that is thought to contribute to the pulmonary exacerbations characteristic of the disease. As compared with treatment with normal saline, twice-daily treatment with inhaled hypertonic saline after the inhalation of a bronchodilator did not affect the linear rate of change in the forced expiratory volume in one second (FEV 1 ) but was associated with improved FEV 1 values and with fewer and shorter pulmonary exacerbations. Twice-daily treatment with inhaled hypertonic saline after the inhalation of a bronchodilator was associated with improved FEV 1 values and with fewer and shorter pulmonary exacerbations. Mutations in the cystic fibrosis gene result in abnormal ion transport across the respiratory epithelium. 1 , 2 In the absence of functional cystic fibrosis transmembrane conductance regulator protein, there is defective chloride secretion and excessive sodium absorption. Among the theories linking this genetic defect to lung disease in patients with cystic fibrosis is the isotonic volume-depletion hypothesis. It proposes that excessive absorption of salt from the airway lumen of patients with cystic fibrosis carries water with it, dehydrating airway mucous secretions and depleting the volume of liquid on the airway surface. These changes disrupt the mucociliary mechanism, with retained mucus becoming . . .