Which of the following is NOT a proposed mechanism of airway clearance with nebulized hypertonic saline?
A. Reduction of mucosal edema
B. Brochodilation
C. Removal of inspissated mucus through osmotic hydration
D. Disruption of mucous strand cross-linking
The answer is B. A recent article showed a 26% reduction in length of stay in infants with viral bronchiolitis treated with hypertonic saline. These are routinely used in children with cystic fibrosis. Although they showed no adverse events, many people mix albuterol/racemic epinephrine with hypertonic saline for fear that hypertonic saline may cause bronchospasm in sensitive individuals (atopic kids).