From the Guidelines
The recommended frequency for using 3% saline solution for lung function is typically 2-4 times daily, as supported by the most recent and highest quality study 1. For patients with conditions like cystic fibrosis or bronchiectasis, 3% hypertonic saline is usually nebulized for 10-15 minutes per session. The standard volume ranges from 4-7 mL per treatment. This therapy should be administered after bronchodilators if the patient uses them, as the hypertonic saline may cause bronchospasm in some individuals. The 3% saline works by drawing water into the airways, which helps thin mucus secretions and makes them easier to cough up and clear from the lungs. This improves airway clearance and lung function by reducing mucus plugging. Some key points to consider when using 3% saline solution include:
- The solution is safe and effective at improving symptoms of mild to moderate bronchiolitis after 24 hours of use and reducing hospital LOS in settings in which the average LOS is more than 3 days, as shown in a 2013 Cochrane review and further supported by subsequent studies 1.
- The preponderance of the evidence suggests that 3% saline is safe and effective, with most studies using a 3% saline concentration and combining it with bronchodilators with each dose 1.
- Patients may experience coughing, throat irritation, or a salty taste during treatment, which is normal and indicates the solution is working.
- For optimal results, airway clearance techniques like huffing or chest physiotherapy should follow the nebulization.
- Patients should rinse their mouth after treatment to remove the salty taste and clean nebulizer equipment according to manufacturer instructions to prevent contamination. It is essential to note that the evidence for the use of hypertonic saline in patients with cystic fibrosis is limited, but one study consisting of a large number of patients over a prolonged period of time showed consistent findings, and the committee determined that HS provided a net benefit that was moderate 1. However, the most recent and highest quality study 1 provides the best guidance for the recommended frequency of 3% saline solution for lung function.
From the Research
Recommended Frequency of 3% Saline Solution for Lung Function
- The recommended frequency of 3% saline solution for lung function is not explicitly stated in the provided studies, but its effectiveness in improving lung function is discussed in several studies 2, 3.
- A study comparing the effects of 3% and 7% hypertonic saline nebulization on lung function in children with cystic fibrosis found that 3% saline nebulization twice daily for 28 days resulted in a significant improvement in lung function compared to 7% saline inhalation 2.
- Another study evaluating the relative effectiveness and tolerability of 0.9% versus 3% versus 6% saline nebulised twice daily found that 3% saline significantly improved lung function and increased the time to first pulmonary exacerbation compared with 0.9% saline 3.
- The optimal frequency of 3% saline solution for lung function may depend on individual patient needs and responses, and further studies are needed to determine the most effective treatment regimen 2, 3.
Key Findings
- 3% hypertonic saline nebulization has been shown to improve lung function in patients with cystic fibrosis 2, 3.
- The effectiveness of 3% saline solution may be comparable to or better than other concentrations, such as 7% saline 2.
- Further studies are needed to determine the optimal concentration, dosage, and administration method for hypertonic saline solutions in treating lung function 4, 5.