Safety and tolerability of inhaled hypertonic saline in young children with cystic fibrosis.

Abstract:

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.

journal_name

Pediatr Pulmonol

journal_title

Pediatric pulmonology

authors

Dellon EP,Donaldson SH,Johnson R,Davis SD

doi

10.1002/ppul.20909

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

1100-1106

issue

11

eissn

8755-6863

issn

1099-0496

journal_volume

43

pub_type

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