Nebulized saline treatment in patients with concomitant asthma and bronchiectasis

Introduction: Asthma is frequently associated with bronchiectasis, with the consequent increase in the number of exacerbations. Treatment with nebulized saline solution (NSS) has shown to improve exacerbations and FEV1 in subjects with bronchiectasis (BQ) not associated with Cystic Fibrosis. Its use in patients with asthma and concomitant BQ, and its effect over asthma exacerbations and control has not been explored yet. Methods: We performed a retrospective study in patients with asthma and BQ from our clinic, treated with NSS at 0.9% (saline), 3%, 5% and 7%. We collected demographic and clinical variables, one year before and after treatment. Using SPSS, a descriptive, frequency and comparative analysis was carried out. Results: We studied 13 patients with asthma and BQ (84,6 % women, mean age of 66,85 years; 76,9% with chronic rhinosinusitis; 100% had daily expectoration, mainly mucopurulent). 46,2% used 0.9% NSS and 53,8% hypertonic NSS (mostly 7%). All of them used high-flow jet nebulizers. A 53,8% reported a decrease in the amount and purulence of sputum. Only 15,4% had bronchospasm. In the subgrup analysis, an improvement in ACT after hypertonic solution was observed (p<0.05). In comparation with saline solution, we found a tendency to improve ACT, use of corticosteroids and antibiotics. Patients with NSS 0,9% improved FVC after treatment (p<0.05). We didn´t find significant differences in FEV1. Conclusion: NSS reduced quantity and purulence of sputum, being well tolerated. ACT improved after use of hypertonic solution. In our sample, NSS at 0.9% improved FVC after treatment. NSS may be useful in asthma and concomitant bronchiectasis. Due to our small sample, further investigations are needed.