Research: Effects of Hypertonic Saline on Bronchiectasis

Encouraging.
Hope they do a long term study also.
How do you find time to do all we need to do for our BE, so kindly respond on Mayo and research also....plus the daily tasks that never end. 😉
Thanks for all.
Barbara

Thank you, Kathy, for posting this.
If I am reading correctly, the inhaled saline, both .9% and 6% gave similar positive results long term. Good news. Makes me wonder if the nebbing itself is more important than the strength of the saline. I have been nebbing 7% saline for over a year now religiously 2x a day. Over this time my coughing has increased both while doing the nebbing and throughout the day, and I generally feel crummy afterward. My scans and Pulmonary Function Tests have remained pretty stable.
Yesterday I had dental surgery which requires me to suspend the nebbing and aerobika for a few days. I feel so much better and have almost no coughing! I have two more days of abstinence to go, so it will be interesting to see how I fare, coughwise. I'm not saying no to nebbing. I firmly believe that it is important for me to clear out the mucus and the bugs swimming around in it. (I have MAC and Pseudomonas along with mild BE). I am wondering, however, if cutting back to a weaker solution (3%), would irritate me less. My concern about doing this is that maybe the MAC and PA would have a more comfortable living arrangement. Does anyone know if there has been a study looking at whether a stronger solution of saline has a greater negative effect on MAC and PA? Thanks for any input you might have.

@bernadene24 You're welcome, Bernadene. I have the exact same question and concerns. I wouldn't make the change based on 1 study, particularly considering the sample size of those with NTMs. I would definitely discuss with both your ID and Pulmonary doctors, particularly since you have a chronic cough-which isn't good either. My NJH doctor last May told me she wanted me to stay on the 7% Hypertonic saline after I briefly went on the 3%. Since then, I have had very low counts: 32, 0,0,0,22,8, and waiting on my 7th sample. About 6 months ago, I developed a bad cough asked her if I could take a break from the 7% and use the 3% and she said it was fine. I'm now back on the 7% since I determined the cough was more asthma related but thinking of talking to her again about maybe go to 3% for a longer period and see if it effects my counts. In your case, I really think you should discuss with your doctors. It's a shame there aren't more studies on this. Also, I have found about 4 or 5 saline studies (I couldn't find the other one I wanted to post) and haven't seen any saline nebulizing studies comparing MAC and Pseudomonas. No doubt in my mind, there would have been more studies (and larger groups for specific treatments) if saline was a $5000/month plus drug.

@blm1007blm1007 It can be exhausting. I have reduced my boiling days to every 5 days. I only boil the aeroclipse tops and put the cups and mouth pieces in my BOLOLO. That has really helped. I now use the aerobika after nebulizing like a flutter valve. My goal is to order more of the aeroclipse and boil just 1/week. I'm also considering getting up earlier:).

@kathyjjb I understand about : "I'm also considering getting up earlier." If my body didn't wake me up two to three times a night I also would like to get up early and have a longer day. I try to be in bed by 10:30 and for me I aim for 7 hours of sleep. Doesn't always happen. I do want to try going to bed earlier to be able to get up earlier.
This week between my PCP and a friend telling me what they know, believe and heard......the philosophy about sleep with how much and when to plan the time to wake each morning ... is getting a bit confusing. My PCP said with regard to sleep and what we hear all the time "we are all different", He said what one person needs is not the same for the other person. Anything I've ever read, previously, says 7 to 8 hours sleep.!?

I have four aeroclipse working each week. I rinse and clean immediately and then I boil two at a time in my glass pyrex pot and place them between a cotton dishtowel to dry. I didn't do the baby bottle sterilizer due to, where do I put this, the 'space' factor etc. Boiling in the pot allows me to get a bit of humidity in the 'dry' house. So I tell myself.
Barbara

@kathyjjb Yes, thanks. I will get in touch with my doc, although that is proving to be a real challenge. I changed back from kaiser to original medicare at the beginning of the year. (Long story, plan was cancelled). Went to one pulmo close to home and that was no good. Finally got an appt. at Georgetown Hospital Bronchiectasis Clinic on April 30. I liked the doctor very much. She went over all my scans with me and explained that I have “traction bronchiectasis” due to scarring of the lungs from something else. She did blood testing to explore possibility of autoimmune disease and said she wanted to confer with some of her colleagues who were expert in fibrous lung issues & she would call me the following week. I heard nothing, so after two weeks, I called her assistant who was out of town (doc had told me if I need anything, to call the assistant), so I emailed the doc. After a week she answered saying she would call me the following day, but I didn’t hear anything. I plan to call her assistant on Monday. I don’t know if my expectations are too high and they are just very busy, but it doesn’t seem like they are very organized. At Kaiser emails were always answered within 2-3 days. Doc were available for calls if you needed them. Sorry for all the grousing. Since the beginning of the year I have been trying to find new docs for everything, get appts., and deal with a new portal for each one—madness! It’s scary not to have my pulmonary services in place.

@blm1007blm1007 I've been having more trouble falling asleep lately. You're like me as for 7-8 hours, my goal is 10:30 but I never seen to get there that early-at least lately. During the summer here in Scottsdale, 10-6 is ideal due to the heat.

@bernadene24 That's so frustrating and I know that feeling all too well! I've switched Pulm doctors 3 times in past 15 years, and the 3rd time was the charm. The first 2, I only had for about a year each. My current pulm doctor responds in 1-2 days. Are you emailing through the patient portal? Can you message the assistant and call? Another option with the saline is to mix the 7% and 3% (if the doctor writes you a script for 3), and see how that effects your coughing. I sure hope you get a hold of the assistant. Good luck and let me know.

I wonder if any subsequent evidence continues to show that isotonic solution (.9%) is equal in efficacy to hypertonic. That would be great news for me since hypertonic tends to make me bleed and I had to discontinue it.

@paxmundi Can you get the 0.9%? Have you tried 3%? Do you have an NTM? The author mentioned a previous study which found the IS not as effective as HS. Or wasn't effective? Regardless, I would definitely be nebulizing with 3% (and 0.9% if 3% was too harsh), if I could not tolerate 7%. Just the quality-of-life graphs showed positive results for the 0.9%.

Yes, more studies are definitely needed. There was a study on inhaled ascorbic glucoside? Or something like that, very mild compared to vitamin C but don't know if it's milder than saline. I vaguely remember Dr Daly (NJG) mentioning it on one of his Brinsupri videos. Apparently, the participants that had the real stuff (not the control group), knew they had the real stuff as the effects/results were amazing. I sure would like to try that!!