Evidence of the case for hypertonic saline for nebbing please

Posted by narelled23 @narelled23, Jul 11 8:40am

Can someone point me to the evidence for hypertonic saline rather than ordinary saline for nebbing, please? My specialist's physio is convinced that the hypertonic is causing me more problems (irritation/inflammation/more mucus) than it may be correcting, and I need to share it with her. Thanking you.

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scoop | @scoop | Jul 11 10:56am

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6688147/

narelled23 | @narelled23 | Jul 12 7:32am

In reply to @scoop "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6688147/" + (show)

Thank you Scoop. It doesn't seem to be the standard recommendation in Australia...despite many people using hypertonic here.

I know I feel so much better on it despite the time, effort and mucus volume produced.

I was going to explore using a lower percentage of hypertonic or trying isotonic...however I don't want to lose the benefits.

Many thanks

scoop | @scoop | Jul 12 9:26am

In reply to @narelled23 "Thank you Scoop. It doesn't seem to be the standard recommendation in Australia...despite many people using..." + (show)

One of the best websites for bronchiectasis learning is out of Australia. I've referenced frequently. Definitely show this to your care team. Apparently, bronchiectasis is a particular problem among indigenous peoples due to dryness and environmental dust.
https://bronchiectasis.com.au/physiotherapy/principles-of-airway-clearance/hydration-and-humidification
"Nebulised saline: Some patients, either due to fluid restrictions or to the viscoelastic properties of their sputum, require further assistance to humidify their airways.

Nebulised saline 0.9% or hypertonic saline 6%-7% may assist with the expectoration of tenacious sputum (Nicolson et al 2012)."

narelled23 | @narelled23 | Jul 12 10:27am

Thank you, Scoop. I am sure she is aware of this. She is knowledgeable, but hesitant about my use of hypertonic saline because of my coughing and volume of mucus.

Sue, Volunteer Mentor | @sueinmn | Jul 12 11:24am

In reply to @narelled23 "Thank you, Scoop. I am sure she is aware of this. She is knowledgeable, but hesitant..." + (show)

You might also want to acquaint her with this new Webinar from Dr McShane on airway clearance - Bronchiectasis patients produce many kinds and volumes of sputum.

narelled23 | @narelled23 | Jul 12 8:35pm

Yes, I found that Youtube video interesting. She said to email evidence to her...although didn't provide the address...got the impression it was easy to find, but can't see it on anything...so she may not be open or interested. I am using the public system and have one further appointment to see the specialist (hopefully, and not the registrar again) and which ever physio is on on that day. I don't think I will be seeing this physio again, since there are about 100 working there...and she hasn't set up an appointment, so obviously feels she can't help me any more.

I would very much like to reduce coughing and throat clearing while nebbing (and at other times) but I find it is an ingrained habit now and at least the coughing is always productive...it is not like I am continually doing dry coughs.

Thank you for your support.