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Research ArticleOriginal Contributions

Effectiveness and Safety of Hypertonic Saline Inhalation Combined With Exercise Training in Patients With Chronic Obstructive Pulmonary Disease: A Randomized Trial

Silvia R Valderramas and Álvaro Nagib Atallah
Respiratory Care March 2009, 54 (3) 327-333;
Silvia R Valderramas
Division of Respiratory Rehabilitation, Department of Physiotherapy, Evangelical University of Paraná, Curitiba, Brasil.
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  • For correspondence: [email protected]
Álvaro Nagib Atallah
Department of Emergency Medicine, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brasil, and with the Brasilian Cochrane Center, São Paulo, Brasil.
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Abstract

BACKGROUND: Inhaled hypertonic saline is used for bronchial challenge and sputum induction in patients with chronic obstructive pulmonary disease (COPD). We studied the effects of saline aerosol inhalation before each exercise session in an 8-week pulmonary rehabilitation program.

METHODS: This was a double-blind randomized parallel controlled trial, conducted at an outpatient clinic. Sixty-eight subjects with COPD (mean age 67 ± 6.5 y, percent of predicted FEV1 47 ± 21) were randomized to inhale either 3% hypertonic saline (34 subjects) or normal saline (34 subjects) before each exercise session in an 8-week exercise program that had 3 sessions per week. We measured 6-min walk distance, dyspnea, and quality of life (with the Medical Outcomes Study 36-item short-form health survey).

RESULTS: After the 8-week exercise program, both groups' mean 6-min walk distance had significantly increased: from 195 ± 92 m to 251 ± 97 m (P < .001) in the hypertonic-saline group, and from 237 ± 93 m to 441 ± 121 m in the normal-saline group (P < .001). The normal-saline group had greater improvement than the hypertonic-saline group (P < .001). Dyspnea score improved from 3.1 ± 0.9 to 2.3 ± 0.8 (P < .01) in the hypertonic-saline group, and from 3.5 ± 0.2 to 2.3 ± 1.0 (P < .01) in the normal-saline group. Quality of life also significantly improved, except for the physical-functioning and social aspect domains in the hypertonic-saline group. Adverse effects (cough or bronchospasm) occurred in 4 patients (12%) in the hypertonic-saline group.

CONCLUSIONS: The improvement in 6-min walk distance was greater with normal saline than with hypertonic saline. Hypertonic saline was associated with adverse effects. It is unclear whether the only predictor of improved functional exercise capacity was exercise training. (ClinicalTrials.gov number, NCT00639236.)

  • chronic obstructive pulmonary disease
  • COPD
  • hypertonic
  • saline
  • exercises
  • dyspnea

Footnotes

  • Correspondence: Silvia R Valderramas PT PhD, Division of Respiratory Rehabilitation, Department of Physiotherapy, Evangelical University of Paraná, Curitiba, Brasil. E-mail: svalderramas{at}uol.com.br.
  • Copyright © 2009 by Daedalus Enterprises Inc.
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Respiratory Care: 54 (3)
Respiratory Care
Vol. 54, Issue 3
1 Mar 2009
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Effectiveness and Safety of Hypertonic Saline Inhalation Combined With Exercise Training in Patients With Chronic Obstructive Pulmonary Disease: A Randomized Trial
Silvia R Valderramas, Álvaro Nagib Atallah
Respiratory Care Mar 2009, 54 (3) 327-333;

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Effectiveness and Safety of Hypertonic Saline Inhalation Combined With Exercise Training in Patients With Chronic Obstructive Pulmonary Disease: A Randomized Trial
Silvia R Valderramas, Álvaro Nagib Atallah
Respiratory Care Mar 2009, 54 (3) 327-333;
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Keywords

  • chronic obstructive pulmonary disease
  • COPD
  • hypertonic
  • saline
  • exercises
  • dyspnea

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