If you look for Pulmosal to buy on the internet, you will see limited availability. It is manufactured or distributed by either Pharma Caribe or WestMed. Maybe you can do a little detective work to find out?

As for "If bronchiectasis is caused by GERD, wouldn’t nebulizing acid into the lungs twice daily worsen the condition?" --- Hmm - First of all, the issue with GERD & bronchiectasis is aspiration of foreign matter into the lungs - not just acid but food particles, then having it rest there as an irritant for many hours, eventually causing damage.

I wouldn't describe nebulizing saline as "nebulizing acid" - and its purpose is to induce coughing to thin and clear the mucus and other secretions in the lungs. The level of acidity in generic hypersaline is not sufficient to have raised concern in studies for people with either bronchiectasis or Cystic Fibrosis. I'm sure if it was a serious issue, NJH would not make it part of their treatment protocol.

Only you can decide about using the saline for yourself. What other measures are you using now?
Sue

pH is a measure of the concentration of hydrogen ions (H+) in a solution.Even 7% saline is only sodium chloride solution，it doesn’t contain any hydrogen ions, so the ph of 7% saline is same with the distilled water not acid liquid.