In infants with cystic fibrosis (CF), preventive inhalation with hypertonic saline (HS) during the first months of life is safe and well tolerated and results in clinical improvements, according to a study recently published in the American Journal of Respiratory and Critical Care Medicine.

Mirjam Stahl, M.D., from the University of Heidelberg in Germany, and colleagues randomly assigned 42 infants (aged <4 months) with CF to twice-daily inhalation of 6 percent HS or 0.9 percent isotonic saline for 52 weeks to assess the feasibility, safety, and efficacy of preventive inhalation strategies.

The researchers found that inhalation of HS and IS was generally well tolerated, with no difference in the number of adverse events between the groups (P = 0.49). The change in lung clearance index during the study period was larger in CF infants treated with HS versus those treated with IS (P < 0.05). Further, in infants treated with HS, weight gain improved over that of the IS group (P < 0.05). Pulmonary exacerbations and chest magnetic resonance imaging scores did not differ between the groups.

"This initial randomized controlled trial supports that preventive treatment with inhaled hypertonic saline is safe and well-tolerated, and has therapeutic benefits on lung function and thriving in the first year of life," the authors write.

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