Impact of high- and low-flow nebulised saline on airway hydration and mucociliary transport
Background Nebulised drugs, including osmotic agents and saline, are increasingly used during noninvasive respiratory support, including nasal high-flow therapy. The authors conducted an in vitro study to compare the hydration effect of nebulised isotonic 0.9% and hypertonic 7.0% saline on mucocilia...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2023-06-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/9/3/00724-2022.full |
| _version_ | 1797689353239003136 |
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| author | Susyn Kelly Matthew Valentine Wei Hang Chua Stanislav Tatkov |
| author_facet | Susyn Kelly Matthew Valentine Wei Hang Chua Stanislav Tatkov |
| author_sort | Susyn Kelly |
| collection | DOAJ |
| description | Background
Nebulised drugs, including osmotic agents and saline, are increasingly used during noninvasive respiratory support, including nasal high-flow therapy. The authors conducted an in vitro study to compare the hydration effect of nebulised isotonic 0.9% and hypertonic 7.0% saline on mucociliary transport.
Methods
In a perfused organ bath, 10 sheep tracheas were exposed to 7.5 mL nebulised 0.9% and 7.0% saline entrained into heated (38°C) and humidified air delivered at high and low flow (20 and 7 L·min−1, respectively). Simultaneous measurements of the airway surface liquid height, mucus transport velocity, cilia beat frequency and surface temperature were made over time. The data are presented as mean±sd.
Results
The airway surface liquid height increased significantly with both 0.9% and 7.0% saline: at low-flow by 37.2±10.0 µm and 152.7±10.9 µm, respectively, and at high-flow by 62.3±5.6 µm and 163.4±25.4 µm, respectively (p<0.001). Mucus velocity was increased by both 0.9% and 7.0% saline from a baseline of 8.2±0.8 mm·min−1 to 8.8±0.7 mm·min−1 and 17.1±0.5 mm·min−1, respectively, with low-flow and at high-flow to 9.8±0.02 mm·min−1 (p=0.04) and 16.9±0.5 mm·min−1 (p<0.05), respectively. Ciliary beating did not change with 0.9% saline, but declined from 13.1±0.6 Hz to 10.2±0.6 Hz and 11.1±0.6 Hz (p<0.05) with 7.0% saline at low- and high-flow, respectively.
Conclusions
The findings demonstrate that nebulised isotonic 0.9% saline, like hypertonic 7.0% saline, significantly stimulates basal mucociliary transport, and the use of high-flow delivery had no significantly different hydration effects compared with low-flow delivery. Hypertonic 7.0% saline suppressed ciliary beating, indicating an increase in airway surface liquid osmolarity, which may have negative effects on the airway surface with frequent use. |
| first_indexed | 2024-03-12T01:44:31Z |
| format | Article |
| id | doaj.art-8b39a1cd4d67491c974684fec24fdb9b |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-12T01:44:31Z |
| publishDate | 2023-06-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-8b39a1cd4d67491c974684fec24fdb9b2023-09-09T13:53:54ZengEuropean Respiratory SocietyERJ Open Research2312-05412023-06-019310.1183/23120541.00724-202200724-2022Impact of high- and low-flow nebulised saline on airway hydration and mucociliary transportSusyn Kelly0Matthew Valentine1Wei Hang Chua2Stanislav Tatkov3 Fisher & Paykel Healthcare, Auckland, New Zealand Department of Biomedical Sciences, Ross University, Basseterre, St Kitts and Nevis School of Health Sciences, Massey University, Palmerston North, New Zealand Fisher & Paykel Healthcare, Auckland, New Zealand Background Nebulised drugs, including osmotic agents and saline, are increasingly used during noninvasive respiratory support, including nasal high-flow therapy. The authors conducted an in vitro study to compare the hydration effect of nebulised isotonic 0.9% and hypertonic 7.0% saline on mucociliary transport. Methods In a perfused organ bath, 10 sheep tracheas were exposed to 7.5 mL nebulised 0.9% and 7.0% saline entrained into heated (38°C) and humidified air delivered at high and low flow (20 and 7 L·min−1, respectively). Simultaneous measurements of the airway surface liquid height, mucus transport velocity, cilia beat frequency and surface temperature were made over time. The data are presented as mean±sd. Results The airway surface liquid height increased significantly with both 0.9% and 7.0% saline: at low-flow by 37.2±10.0 µm and 152.7±10.9 µm, respectively, and at high-flow by 62.3±5.6 µm and 163.4±25.4 µm, respectively (p<0.001). Mucus velocity was increased by both 0.9% and 7.0% saline from a baseline of 8.2±0.8 mm·min−1 to 8.8±0.7 mm·min−1 and 17.1±0.5 mm·min−1, respectively, with low-flow and at high-flow to 9.8±0.02 mm·min−1 (p=0.04) and 16.9±0.5 mm·min−1 (p<0.05), respectively. Ciliary beating did not change with 0.9% saline, but declined from 13.1±0.6 Hz to 10.2±0.6 Hz and 11.1±0.6 Hz (p<0.05) with 7.0% saline at low- and high-flow, respectively. Conclusions The findings demonstrate that nebulised isotonic 0.9% saline, like hypertonic 7.0% saline, significantly stimulates basal mucociliary transport, and the use of high-flow delivery had no significantly different hydration effects compared with low-flow delivery. Hypertonic 7.0% saline suppressed ciliary beating, indicating an increase in airway surface liquid osmolarity, which may have negative effects on the airway surface with frequent use.http://openres.ersjournals.com/content/9/3/00724-2022.full |
| spellingShingle | Susyn Kelly Matthew Valentine Wei Hang Chua Stanislav Tatkov Impact of high- and low-flow nebulised saline on airway hydration and mucociliary transport ERJ Open Research |
| title | Impact of high- and low-flow nebulised saline on airway hydration and mucociliary transport |
| title_full | Impact of high- and low-flow nebulised saline on airway hydration and mucociliary transport |
| title_fullStr | Impact of high- and low-flow nebulised saline on airway hydration and mucociliary transport |
| title_full_unstemmed | Impact of high- and low-flow nebulised saline on airway hydration and mucociliary transport |
| title_short | Impact of high- and low-flow nebulised saline on airway hydration and mucociliary transport |
| title_sort | impact of high and low flow nebulised saline on airway hydration and mucociliary transport |
| url | http://openres.ersjournals.com/content/9/3/00724-2022.full |
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