Type of publication:
Conference abstract
Author(s):
*Johnson J.; *Ahmad N.;
Citation:
Thorax. Conference: British Thoracic Society Winter Meeting 2025. Westminster . 80(Supplement 2) (pp A151-A152), 2025. Date of Publication: 01 Nov 2025.
Abstract:
Background 7% Hypertonic saline (HTS) is increasingly being used as a mucolytic therapy in patients with chronic respiratory conditions, particularly those with mucus retention and impaired airway clearance. Despite its widespread use, data on the effectiveness of HTS and its potential impact on healthcare utilisation remain sparse. Understanding its role in symptom relief and hospital admission rates is critical in optimising treatment. Aim The primary outcome was to observe an improvement in symptoms. The secondary outcome looked at reduction in hospital admissions comparing 12 months before HTS initiation with 12 months post-initiation. Method This was a retrospective cohort study from March 2023 to February 2025. We identified patients initiated on HTS, through a logbook maintained by specialist respiratory nurses. Improvement in symptoms meant improved cough, ease of mucus expectoration and change in mucus colour, which was reported in clinic letters. We also collected data of their highest Blood eosinophil count (BEC) during this period. We used MS Excel and Vassar stats (vassarstats.net) for calculations. Results A total of 36 patients were initiated on HTS, of which 42% (n=15) had Bronchiectasis, 8% (n=3) had COPD, 22% had Asthma (n=8), 11% had Asthma-COPD overlap (4) and 17% were labelled as others (n=6). Mean Age was 65 years (SD 10) with 56% females. 67% had BEC >0.3 x109/L. 72% (n=26) reported symptomatic improvement of which notably 42% (n=11) had Bronchiectasis, 27% had Asthma (n=7) and 15% (n= 4) had Asthma-COPD. 25% (n=9) noted no benefit and 1 patient's data was not found. Subjects showing symptom improvement had a higher mean BEC (0.45×109/L v .27×109/L, p=0.01) when compared with those who did not show any improvement. Our secondary outcome measure showed no effect on hospital admissions following initiation of HTS. However, 4 of 6 patients who were hospitalised over the next 12 months reported a symptomatic improvement. Conclusion Majority of patients with Bronchiectasis, Asthma and Asthma-COPD overlap derive symptomatic benefit from HTS treatment. Improvement in patients with BEC>0.3 was statistically significant, suggesting higher degree of mucus impaction in this group. HTS probably does not affect hospital admissions; but requires further validation.
DOI: 10.1136/thorax-2025-BTSabstracts.219
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