EFFECT OF HYPERTONIC SALINE, AMILORIDE, AND COUGH ON MUCOCILIARY CLEARANCE IN PATIENTS WITH CYSTIC-FIBROSIS

In patients with cystic fibrosis (CF), dehydration of airway secretion s leads to a decrease in mucociliary clearance (MCC). We examined the acute effect on MCC of a single administration by aerosolization of hy pertonic saline (7%) (HS), amiloride (0.3% in 0.12% NaCl) (AML) and a combination of AML and HS (AM L + HS) in 12 patients with CF using a r adioaerosol technique. Isotonic saline [0.9%] (IS) was used as a contr ol solution. As both the AML and HS solutions induced cough in some pa tients, the last nine patients studied also underwent a cough clearanc e day. This was to eliminate the possible confounding effect of cough on MCC measurement. Patients ranged from 18 to 28 yr (mean +/- SD, 22 +/- 3) with an FEV(1) of 27 to 112% predicted (61 +/- 30%). Following deposition of the radioaerosol, baseline clearance was assessed for 30 min. This was followed by a 30-min intervention period. Assessment of post-intervention clearance for a further 30 min was then performed. Comparison of the amount of radioaerosol cleared from the right lung w as made at 60 min (%C60) and 90 min (%C90) using repeated measures ANO VA. The percent cleared at 60 and 90 min was significantly increased w ith HS (%C60 = 26.5%, %C90 = 29.4%) and the combination of AML + HS (% C60 = 23.1%, %C90 = 27.4%) compared with both IS (%C60 = 14.7%, %C90 = 17.5%) and COUGH (%C60 = 18.0%, %C90 = 19.5%), p < 0.01. Inhalation o f hypertonic saline is a potentially useful treatment in patients with cystic fibrosis.