EFFICIENCY OF HYPERTONIC SOLUTION INHALATION IN CHILDREN WITH BRONCHITIS AND BRONCHIOLITIS
https://doi.org/10.15690/vsp.v13i4.1082
Abstract
Background: Chronic bronchitis and bronchiolitis in children with congenital malformation are often characterized by the severe course of disease. The efficiency of treatment of those conditions can be increased through addition of sodium chloride (NaCl), hypertonic saline which takes a hydrostatic and osmotic effect on mucous membrane of the bronchial tree in broncholytic therapy. Aim: To evaluate the efficiency of 3% NaCl hypertonic solution inhalation in children with chronic bronchitis/bronchiolitis in the setting of bronchi congenital malformation (Kartagener's syndrome and primary ciliary dyskinesia). Patients and methods: The participants
of this study were 28 children in the age of 4–17.5 years with chronic bronchitis/bronchiolitis in the setting of Kartagener's syndrome and primary ciliary dyskinesia in the first days o facute exacerbation of the disease (15 patients in treatment group and 13 patients in control group). In the therapy scheme of treatment group the 3 NaCl hypertonic solution in administered dose of 2 ml was applied 2 times/day during 14 days besides other treatment methods. Results: In patients with chronic bronchiolitis 3% NaCl hypertonic saline inhalation in administered dose of 2 ml twice a day had improved the clinical presentation of disease; by the 14th day of study
the FEV-1 value improved from 70.0 ± 2.1 to 82 ± 3.2% (p = 0.024). The side effects in form of cough aggravation were registered in 13% cases. Among additional criteria of efficiency the improvement of MОС-75 from 52.1 ± 5.2 to 71.2 ± 1.4% (p = 0.011) was also marked in patients. The adverse experience, such as shivering, hypoexcitability and sleep disturbance, were registered in 7% of cases. Conclusion: Inhalation of 3% NaCl hypertonic saline allows the fast arresting of wheezing and eliminates the mycostasis in children with chronic bronchitis/bronchiolitis.
of this study were 28 children in the age of 4–17.5 years with chronic bronchitis/bronchiolitis in the setting of Kartagener's syndrome and primary ciliary dyskinesia in the first days o facute exacerbation of the disease (15 patients in treatment group and 13 patients in control group). In the therapy scheme of treatment group the 3 NaCl hypertonic solution in administered dose of 2 ml was applied 2 times/day during 14 days besides other treatment methods. Results: In patients with chronic bronchiolitis 3% NaCl hypertonic saline inhalation in administered dose of 2 ml twice a day had improved the clinical presentation of disease; by the 14th day of study
the FEV-1 value improved from 70.0 ± 2.1 to 82 ± 3.2% (p = 0.024). The side effects in form of cough aggravation were registered in 13% cases. Among additional criteria of efficiency the improvement of MОС-75 from 52.1 ± 5.2 to 71.2 ± 1.4% (p = 0.011) was also marked in patients. The adverse experience, such as shivering, hypoexcitability and sleep disturbance, were registered in 7% of cases. Conclusion: Inhalation of 3% NaCl hypertonic saline allows the fast arresting of wheezing and eliminates the mycostasis in children with chronic bronchitis/bronchiolitis.
Supporting agencies: “PARI synergism in medicine” Ltd.
About the Authors
O. I. Simonova
Scientific Centre of Children’s Health, Moscow
Russian Federation
Russian Federation
Yu. V. Gorinova
Scientific Centre of Children’s Health, Moscow
Russian Federation
Russian Federation
M. D. Bakradze
Scientific Centre of Children’s Health, Moscow
Russian Federation
Russian Federation
References
1. Mukoaktivnaya terapiya. Pod red. A. G. Chuchalina, A. S. Belevsko go [Mucoactive Therapy. Edited by A. G. Chuchalin, A. S. Belevskii]. Moscow, Atmosfera, 2006. 124 p.
2. Simonova O. I. Vopr. sovr. pediatrii — Current pediatrics. 2013; 12 (4): 136–141.
3. Patrusheva Yu. S., Bakradze M. D. Vopr. diagnostiki v pediatrii — Diagnostics in pediatrics. 2012; 4 (3): 45–52.
4. Simonova O. I., Tomilova A.Yu., Gorinova Yu. V., Surkov A. N., Roslavtseva E. A., Namazova-Baranova L. S. Mukovistsidoz. V serii kn.: Bolezni detskogo vozrasta ot A do Ya. Vyp. 5 [Cystic Fibrosis. In a series of books: Childhood Diseases from A to Z. Vol. 5]. Moscow, Pediatr””, 2014. 84 p.
5. Mall M., Grubb B. R., Harkema J. R., O'Neal W. K., Boucher R. C. Increased airway epithelial Na+ absorption produces cystic fibrosislike lung disease in mice. Nature Medicine. 2004; 10: 487–493.
6. Robinson M., Hemming A. L., Regnis J. A., Wong A. G., Bailey D. L., Bautovich G. J. Effect of increasing doses of hypertonic saline on mucociliary clearance in patients with cystic fibrosis. Thorax. 1997; 52: 900–903.
7. Donaldson S. H., Bennett W. D., Zeman K. L., Knowles M. R., Tarran R., Boucher R. C. Mucus clearance and lung function in cystic fibrosis with hypertonic saline. N. Engl. J. Med. 2006; 354: 241–250.
8. Elkins M. R., Robinson M., Rose B. R., Harbour C., Moriarty C. P., Marks G. B. A controlled trial of long-term inhaled hypertonic saline in patients with cystic fibrosis. N. Engl. J. Med. 2006; 354 (3): 229–240.
9. Graeber S. Y., Zhou-Suckow Z., Schatterny J., Hirtz S., Boucher R. C., Mall M. A. Hypertonic saline is effective in the prevention and treatment of mucus obstruction, but not airway inflammation, in mice with chronic obstructive lung disease. Am. J. Respir. Cell & Mol. Biol. 2013; 49: 410–417.
10. Wark P., McDonald V. M. Nebulised hypertonic saline for cystic fibrosis. Cochr. Database Syst. Rev. 2009; 2: CD001506.
11. Dellon E. P., Donaldson S. H., Johnson R., Davis S. D. Safety and Tolerability of Inhaled Hypertonic Saline in Young Children With Cystic Fibrosis. Pediatr. Pulmonol. 2008; 43: 1100–1106.
12. Rosenfeld M., Davis S., Brumback L. Inhaled Hypertonic Saline in Infants and Toddlers with Cystic Fibrosis: Short-Term Tolerability, Adherence and Safety. Pediatr. Pulmonol. 2011; 46 (7): 666–671.
13. Amin R., Subbarao P., Jabar A., Balkovec S., Jensen R., Kerrigan S. Hypertonic saline improves the LCI in paediatric patients with CF with normal lung function. Thorax. 2010; 65 (5): 379–383.
14. Rosenfeld M., Ratjen F., Brumback L., Daniel S., Rowbotham R., McNamara S. Inhaled hypertonic saline in infants and children younger than 6 years with cystic fibrosis: the ISIS randomized controlled trial. JAMA. 2012; 307 (21): 2269–2277.
15. Subbarao P., Stanojevic S., Brown M., Jensen R., Rosenfeld M., Davis S., Brumback L., Gustafsson P., Ratjen F. Lung clearance index as an outcome measure for clinical trials in young children with cystic fibrosis: a pilot study using inhaled hypertonic saline. Am. J. Respir. Crit. Care Med. 2013; 188 (4): 456–460.
16. Davis S. D., Rosenfeld M., Brumback L. Infants PFTs as an endpoint in the infant study of inhaled saline randomized controlled trial. Pediatr. Pulmonol. 2012; 35: 225.
17. Elkins M., Dentice R. Timing of hypertonic saline inhalation for cystic fibrosis. Cochr. Database Syst. Rev. 2012; 2: CD008816.
18. Gorinova Yu. V., Simonova O. I., Tomilova A.Yu., Roslavtseva E. A. Vopr. sovr. pediatrii — Current pediatrics. 2013; 5: 30–38.
19. Mukovistsidoz. Pod red. N. I. Kapranova, N.Yu. Kashirskoi [Cystic Fibrosis. Edited by N. I. Kapranov, N.Yu. Kashirskaya]. Moscow, Medpraktika-M, 2014. pp. 423–425.
20. Quan J. M., Tiddens H. A., Sy J. P., McKenzie S. G., Montgomery M. D., Robinson P. J. Pulmozyme Early Intervention Trial Study Group. A two-year randomized, placebo-controlled trial of dornase alfa in young patients with cystic fibrosis with mild lung function abnormalities. J. Pediatr. 2001; 139: 813–820.
21. Clement A., Tamalet A., Le Roux E., Ravilly S., Fauroux B., Jais J. P. Long term effects of azithromycin in patients with cystic fibrosis: a double-blind, placebo-controlled trial. Thorax. 2006; 61: 895–902.
22. Rabin H. R., Butler S. M., Wohl M. E. B., Geller D. E., Colin A. A., Schidlow D. V. Pulmonary exacerbations in cystic fibrosis. Pediatr. Pulmonol. 2004; 37: 400–406.
23. Wark P. A., McDonald V., Jones A. P. Nebulised hypertonic saline for cystic fibrosis. Cochr. Database Syst. Rev. 2005; 20: CD001506.
24. Suri R., Metcalfe C., Lees B., Grieve R., Flather M., Normand C. Comparison of hypertonic saline and alternate-day or daily recombinant human deoxyribonuclease in children with cystic fibrosis: a randomised trial. Lancet. 2001; 358: 1316–1321.
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For citations:
Simonova O.I., Gorinova Yu.V., Bakradze M.D. EFFICIENCY OF HYPERTONIC SOLUTION INHALATION IN CHILDREN WITH BRONCHITIS AND BRONCHIOLITIS. Current Pediatrics. 2014;13(4):33-39. (In Russ.) https://doi.org/10.15690/vsp.v13i4.1082
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