RESUMO
Introducción: El suero salino hipertónico (SSH) nebulizado mejora la calidad de vida y reduce las exacerbaciones en pacientes con fibrosis quística. Se desconoce si ofrecería los mismos beneficios en otras patologías hipersecretoras.MétodosEstudio observacional retrospectivo. Se incluyeron pacientes que superaron la prueba de tolerancia e iniciaron SSH al 5,8% con un año de seguimiento. Se cuantificaron parámetros clínicos y asistenciales en los años previo y posterior al inicio del tratamiento.ResultadosUn total de 101 pacientes, 60,4% mujeres, media de edad 65años (IC95%: 62,4-67,9): 82 (81,2%) bronquiectasias, 6 (5,9%) EPOC, 2 (2%) asma, 1 (1%) EPID y 10 (9,9%) otros. Se evidenció una reducción de la broncorrea (91,1% vs 75,2%), de las infecciones de repetición (57,4% vs 22,8%) y de los ciclos de antibioterapia (1,54 vs 0,55), así como un aumento del FEV1 (1.881ml vs 1.942ml) y una disminución de las asistencias a atención primaria (2,94 vs 1,1), de urgencias (0,36 vs 0,17) y de hospitalizaciones (0,17 vs 0,06). Setenta y tres pacientes (72,3%) presentaron una adecuada tolerancia.ConclusiónLa nebulización de SSH al 5,8% en pacientes con hipersecreción bronquial es segura y tiene un destacable impacto clínico y asistencial. (AU)
Introduction: Nebulized hypertonic saline (HS) improves quality of life and reduces exacerbations in patients with cystic fibrosis. It is unknown if it would offer the same benefits in other hypersecretory pathologies.MethodsRetrospective observational study. Patients who passed the tolerance test and started HS 5.8% with one year of follow-up were included. Clinical and healthcare parameters were quantified in the year before and after the start of treatment.Results101 patients, 60.4% women, 65years (95%CI: 62.4-67.9): 82 (81.2%) bronchiectasis, 6 (5.9%) COPD, 2 (2%) asthma, 1 (1%) ILD, and 10 (9.9%) other causes. There was a reduction in bronchorrhea (91.1% vs 75.2%), recurrent infections (57.4% vs 22.8%) and cycles of antibiotic therapy (1.54 vs 0.55), as well as an increase in FEV1 (1881ml vs. 1942ml) and a decrease in visits to primary care (2.94 vs. 1.1), emergencies (0.36 vs. 0.17) and hospitalizations (0.17 vs. 0.17). 06). 73 patients (72.3%) presented an adequate tolerance.ConclusionNebulization of HS 5.8% in patients with bronchial hypersecretion is safe and has a remarkable clinical and healthcare impact. (AU)
Assuntos
Humanos , Organização e Administração , Brônquios , Fibrose Cística , Solução Salina Hipertônica/efeitos adversos , Solução Salina Hipertônica/uso terapêutico , Nebulizadores e Vaporizadores , Qualidade de VidaRESUMO
INTRODUCTION: Nebulized hypertonic saline (HS) improves quality of life and reduces exacerbations in patients with cystic fibrosis. It is unknown if it would offer the same benefits in other hypersecretory pathologies. METHODS: Retrospective observational study. Patients who passed the tolerance test and started HS 5.8% with one year of follow-up were included. Clinical and healthcare parameters were quantified in the year before and after the start of treatment. RESULTS: 101 patients, 60.4% women, 65years (95%CI: 62.4-67.9): 82 (81.2%) bronchiectasis, 6 (5.9%) COPD, 2 (2%) asthma, 1 (1%) ILD, and 10 (9.9%) other causes. There was a reduction in bronchorrhea (91.1% vs 75.2%), recurrent infections (57.4% vs 22.8%) and cycles of antibiotic therapy (1.54 vs 0.55), as well as an increase in FEV1 (1881ml vs. 1942ml) and a decrease in visits to primary care (2.94 vs. 1.1), emergencies (0.36 vs. 0.17) and hospitalizations (0.17 vs. 0.17). 06). 73 patients (72.3%) presented an adequate tolerance. CONCLUSION: Nebulization of HS 5.8% in patients with bronchial hypersecretion is safe and has a remarkable clinical and healthcare impact.
Assuntos
Bronquiectasia , Fibrose Cística , Humanos , Feminino , Masculino , Qualidade de Vida , Administração por Inalação , Bronquiectasia/tratamento farmacológico , Brônquios , Solução Salina Hipertônica/uso terapêutico , Solução Salina Hipertônica/efeitos adversos , Nebulizadores e VaporizadoresRESUMO
BACKGROUND: The role of hyaluronic acid plus hypertonic saline (HA+HS) as a mucoactive treatment in patients with bronchiectasis is still unknown. This study evaluated whether HA+HS solution enhances similar sputum quantity with better safety profile than HS alone in patients with bronchiectasis. METHODS: In this double-blind randomized crossover trial, three solutions (7% HS; 0.1% HA +7%HS; and 0.9% isotonic saline, IS) were compared in outpatients with bronchiectasis and chronic sputum expectoration. Participants inhaled each solution across four consecutive sessions. All sessions, except on session 3, also included 30 minutes of airway clearance technique. A 7-day washout period was applied. Sputum weight was collected during the sessions (primary outcome) as well as during a 24-hour follow-up. The Leicester Cough Questionnaire (LCQ) and lung function were measured before/after each treatment arm. Safety was assessed by the monitoring of adverse events (AEs). RESULTS: Twenty-eight patients with bronchiectasis (mean age of 64.0 (17.9) and FEV1% 60.9 (24.6) of predicted) were recruited. HS and HA+HS promoted similar expectoration during sessions, both being greater than IS [median difference HS vs. IS 3.7 g (95% CI 0.5-6.9); HA+HS vs. IS 3.2 g (95%CI 0.5-5.9)]. Sputum expectorated exclusively during the ACT period was similar across all treatment arms [HS vs. IS -0.3 g (95% CI -1.7 to 0.9); HA+HS vs. IS 0.0 g (95% CI -1.3 to 1.4); HS vs. HA+HS 0.0 g (95% CI -1.2 to 0.4)]. Sputum collected over the 24-hour follow-up tended to be lower for HS and HA+HS compared with IS [HS vs. IS -1.7 g (95% CI -4.2 to 0.0); HA+HS vs. IS -1.1 g (95%CI -3.6 to 0.7)]. No differences in LCQ or lung function were observed. Most severe AEs were reported using HS. CONCLUSION: HS and HA+HS were more effective on sputum expectoration than IS in patients with bronchiectasis, reporting HA+HS better safety profile than HS.
