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Safety and tolerability of inhaled hypertonic saline in young children with cystic fibrosis
Author(s) -
Dellon Elisabeth P.,
Donaldson Scott H.,
Johnson Robin,
Davis Stephanie D.
Publication year - 2008
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20909
Subject(s) - medicine , hypertonic saline , cystic fibrosis , spirometry , tolerability , vital capacity , pediatrics , population , pulmonary function testing , adverse effect , anesthesia , asthma , lung , lung function , environmental health , diffusing capacity
Background Inhaled hypertonic saline (HS) improves lung function and decreases pulmonary exacerbations in older patients with cystic fibrosis (CF). Initiating therapies in young patients has potential to preserve lung function. Before conducting a therapeutic trial of HS in this population, its safety must be evaluated and protocols for monitoring response must be tested. Methods We administered single dose 3% and 7% HS post‐albuterol to 4–7 year‐olds with CF able to perform spirometry (“preschool” group) and 4 month to 3 year‐olds (“infant” group) using the raised volume rapid thoracoabdominal compression technique (RVRTC). Vital signs and cough episodes were measured after each inhaled treatment. Results Eight preschool subjects (mean age 5.7 ± 0.8 years) and 6 infants (1.6 ± 1.0 years) completed the 3% HS protocol, and no clinically important change in vital signs or decrease in FVC, FEV 1 , FEV 0.5 , or FEF 25–75 occurred post‐HS. Preschoolers had more cough episodes post‐HS ( P = 0.01). Seven preschoolers (6.1 ± 0.7 years) and 8 infants (1.6 ± 0.7 years) completed the 7% HS protocol. In the preschool group, FVC, FEV 0.5 , and FEF 25–75 did not change significantly. A statistically significant drop in median FEV 1 occurred post‐7% HS attributable to a transient >20% drop in one subject. Infant PFT parameters were unchanged post‐7% HS. Preschoolers had more cough episodes post‐HS ( P = 0.03). Conclusion Acute administration of 3% and 7% HS appears to be safe and well‐tolerated in most young children with CF. Given the demonstrated benefits in older patients, a therapeutic trial in this age group is warranted. Pediatr Pulmonol. 2008; 43:1100–1106. © 2008 Wiley‐Liss, Inc.