Cochrane · systematic review · CD001506

Nebulised hypertonic saline for cystic fibrosis

Wark, P, McDonald, VM, Smith, S · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library

Cystic Fibrosis and Genetic Disorders2 versionsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
56
current version
GRADE rated
25
No studies
31
Included studies
NR
No studies 31 · 55.4%Ungraded 0 · 0%Very low 19 · 33.9%Low 6 · 10.7%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Questions and results

Show all 2 versions

Hypertonic saline 3% to 7% versus isotonic saline for cystic fibrosis (stable lung disease)

Population: adults and children with cystic fibrosis (stable lung disease)
7 questions
OutcomeEffectEvidenceStatus / GRADE
FEV1 (% predicted) change from baseline, short‐term
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extracted4 studies · 246 participantsVery low
Downgraded: risk of bias, imprecision, inconsistency, indirectness
FEV1 (% predicted) change from baseline, long‐term
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extracted1 study · 134 participantsLow
Downgraded: risk of bias, indirectness
LCI
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extracted1 study · 10 participantsVery low
Downgraded: imprecision, indirectness
Mortality
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extractedNRNo studies
Measures of sputum clearance
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extracted4 studies · 80 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Pulmonary exacerbations
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extracted4 studies · 607 participantsVery low
Downgraded: risk of bias, inconsistency, indirectness
Adverse events
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extracted3 studies · 513 participantsLow
Downgraded: risk of bias, indirectness

Hypertonic saline 3% to 7% versus isotonic saline for cystic fibrosis (during acute exacerbations of lung disease)

Population: adults and children with cystic fibrosis (during acute exacerbations of lung disease)
7 questions
OutcomeEffectEvidenceStatus / GRADE
FEV1 (% predicted) change from baseline, short‐term
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extracted1 study · 130 participantsLow
Downgraded: risk of bias, indirectness
FEV1 (% predicted) change from baseline, long‐term
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extractedNRNo studies
LCI
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extractedNRNo studies
Mortality
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extracted2 studies · 142 participantsLow
Downgraded: risk of bias, indirectness
Measures of sputum clearance
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extractedNRNo studies
Pulmonary exacerbations
Hypertonic saline 3% to 7% vs isotonic saline
HR 0.86 [0.57, 1.3]1 study · 132 participantsLow
Downgraded: risk of bias, indirectness
Adverse events
Hypertonic saline 3% to 7% vs isotonic saline
no estimate extracted2 studies · 142 participantsVery low
Downgraded: risk of bias, imprecision, indirectness

Hypertonic saline compared with rhDNase with for cystic fibrosis

Population: adults and children with cystic fibrosis
7 questions
OutcomeEffectEvidenceStatus / GRADE
FEV1 (% predicted) change from baseline, short‐term
Hypertonic saline vs rhDNase with
no estimate extracted1 study · 14 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
FEV1 (% predicted) change from baseline, long‐term
Hypertonic saline vs rhDNase with
no estimate extracted1 study · 47 participantsVery low
Downgraded: imprecision, indirectness
LCI
Hypertonic saline vs rhDNase with
no estimate extractedNRNo studies
Mortality
Hypertonic saline vs rhDNase with
no estimate extractedNRNo studies
Measures of sputum clearance
Hypertonic saline vs rhDNase with
no estimate extractedNRNo studies
Pulmonary exacerbations
Hypertonic saline vs rhDNase with
no estimate extracted1 study · 47 participantsVery low
Downgraded: imprecision, indirectness
Adverse events
Hypertonic saline vs rhDNase with
no estimate extracted1 study · 47 participantsVery low
Downgraded: imprecision, indirectness

Hypertonic saline compared with amiloride for cystic fibrosis

Population: adults and children with cystic fibrosis
7 questions
OutcomeEffectEvidenceStatus / GRADE
FEV1: change from baseline, short‐term
Hypertonic saline vs amiloride
no estimate extractedNRNo studies
FEV1: change from baseline, long‐term
Hypertonic saline vs amiloride
no estimate extractedNRNo studies
LCI
Hypertonic saline vs amiloride
no estimate extractedNRNo studies
Mortality
Hypertonic saline vs amiloride
no estimate extractedNRNo studies
Measures of sputum clearance
Hypertonic saline vs amiloride
no estimate extracted1 study · 12 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Pulmonary exacerbations
Hypertonic saline vs amiloride
no estimate extractedNRNo studies
Adverse events
Hypertonic saline vs amiloride
no estimate extractedNRNo studies

Hypertonic saline compared with sodium‐2‐mercaptoethane sulphonate (Mistabron®) for cystic fibrosis

Population: adults and children with cystic fibrosis
7 questions
OutcomeEffectEvidenceStatus / GRADE
FEV1: short‐term
Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®)
no estimate extractedNRNo studies
FEV1: long‐term
Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®)
no estimate extractedNRNo studies
LCI
Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®)
no estimate extractedNRNo studies
Mortality
Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®)
no estimate extractedNRNo studies
Measures of sputum clearance
Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®)
no estimate extracted1 study · 29 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Pulmonary exacerbations
Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®)
no estimate extracted1 study · 29 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Adverse events
Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®)
no estimate extracted1 study · 29 participantsVery low
Downgraded: risk of bias, imprecision, indirectness

Hypertonic saline compared with mannitol for cystic fibrosis

Population: adults and children with cystic fibrosis
7 questions
OutcomeEffectEvidenceStatus / GRADE
FEV1: short‐term
Hypertonic saline vs mannitol
no estimate extracted1 study · 12 participantsVery low
Downgraded: risk of bias, indirectness
FEV1: long‐term
Hypertonic saline vs mannitol
no estimate extractedNRNo studies
LCI
Hypertonic saline vs mannitol
no estimate extractedNRNo studies
Mortality
Hypertonic saline vs mannitol
no estimate extractedNRNo studies
Measures of sputum clearance
Hypertonic saline vs mannitol
no estimate extracted1 study · 12 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
Pulmonary exacerbations
Hypertonic saline vs mannitol
no estimate extractedNRNo studies
Adverse events
Hypertonic saline vs mannitol
no estimate extracted1 study · 12 participantsVery low
Downgraded: risk of bias, imprecision, indirectness

Hypertonic saline 7% versus xylitol for cystic fibrosis

Population: adults with cystic fibrosis
7 questions
OutcomeEffectEvidenceStatus / GRADE
FEV1 (% predicted) change from baseline, short‐term
Hypertonic saline 7% vs xylitol
no estimate extracted2 studies · 89 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
FEV1 (% predicted) change from baseline, long‐term
Hypertonic saline 7% vs xylitol
no estimate extractedNRNo studies
LCI
Hypertonic saline 7% vs xylitol
no estimate extractedNRNo studies
Mortality
Hypertonic saline 7% vs xylitol
no estimate extractedNRNo studies
Measures of sputum clearance
Hypertonic saline 7% vs xylitol
no estimate extractedNRNo studies
Pulmonary exacerbations
Hypertonic saline 7% vs xylitol
no estimate extracted1 study · 59 participantsLow
Downgraded: imprecision, indirectness
Adverse events: serious adverse events
Hypertonic saline 7% vs xylitol
no estimate extracted2 studies · 89 participantsVery low
Downgraded: risk of bias, imprecision, indirectness

Hypertonic saline 7% versus hypertonic saline 3% for cystic fibrosis

Population: children with cystic fibrosis
7 questions
OutcomeEffectEvidenceStatus / GRADE
FEV1 (% predicted) change from baseline, short‐term
Hypertonic saline 7% vs hypertonic saline 3%
no estimate extracted1 study · 30 participantsVery low
Downgraded: risk of bias, imprecision, indirectness
FEV1 (% predicted) change from baseline, long‐term
Hypertonic saline 7% vs hypertonic saline 3%
no estimate extractedNRNo studies
LCI
Hypertonic saline 7% vs hypertonic saline 3%
no estimate extractedNRNo studies
Mortality
Hypertonic saline 7% vs hypertonic saline 3%
no estimate extractedNRNo studies
Measures of sputum clearance
Hypertonic saline 7% vs hypertonic saline 3%
no estimate extractedNRNo studies
Pulmonary exacerbations
Hypertonic saline 7% vs hypertonic saline 3%
no estimate extractedNRNo studies
Adverse events
Hypertonic saline 7% vs hypertonic saline 3%
no estimate extractedNRNo studies