Salt water (3% or more salt) inhaled as a fine mist through a mask or mouthpiece for cystic fibrosis

People with cystic fibrosis produce mucus in their lungs and airways (passages to the lungs) which is hard to clear. This leads to infections and damage to the airways. Chest physiotherapy or drugs (e.g. deoxyribonuclease) or both are used to try and clear this mucus. Nebulised hypertonic saline is water (with a concentration of 3% or more salt) inhaled as a fine mist through a mask or mouthpiece. The review includes twelve trials with a total of 442 people. We found that 10 ml of saline at 3% to 7% concentration, twice-a-day, helped clear mucus without major adverse effects. Treatment after 48 weeks with hypertonic saline at 7% inhaled twice per day reduces episodes of chest infection and is linked to improved lung function, improved quality of life and better attendance at school or work. However, it had a limited effect on improving lung function. At this stage the authors believe there is enough evidence to recommend the use of hypertonic saline in cystic fibrosis. However we would like to point out that the only long term trial did not determine its primary outcome (lung function) and saw improvements only in secondary outcomes.