Cochrane · systematic review · CD001506
Nebulised hypertonic saline for cystic fibrosis
Wark, P, McDonald, VM, Smith, S · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
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
Current version onlyHypertonic saline 3% to 7% versus isotonic saline for cystic fibrosis (stable lung disease)
Population: adults and children with cystic fibrosis (stable lung disease)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 (% predicted) change from baseline, short‐term Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 4 studies · 246 participants | Very 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 extracted | 1 study · 134 participants | Low Downgraded: risk of bias, indirectness |
LCI Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 1 study · 10 participants | Very low Downgraded: imprecision, indirectness |
Mortality Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 4 studies · 80 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pulmonary exacerbations Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 4 studies · 607 participants | Very low Downgraded: risk of bias, inconsistency, indirectness |
Adverse events Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 3 studies · 513 participants | Low 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)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 (% predicted) change from baseline, short‐term Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 1 study · 130 participants | Low Downgraded: risk of bias, indirectness |
FEV1 (% predicted) change from baseline, long‐term Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | NR | No studies |
LCI Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | NR | No studies |
Mortality Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 2 studies · 142 participants | Low Downgraded: risk of bias, indirectness |
Measures of sputum clearance Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | NR | No studies |
Pulmonary exacerbations Hypertonic saline 3% to 7% vs isotonic saline | HR 0.86 [0.57, 1.3] | 1 study · 132 participants | Low Downgraded: risk of bias, indirectness |
Adverse events Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 2 studies · 142 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Hypertonic saline compared with rhDNase with for cystic fibrosis
Population: adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 (% predicted) change from baseline, short‐term Hypertonic saline vs rhDNase with | no estimate extracted | 1 study · 14 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
FEV1 (% predicted) change from baseline, long‐term Hypertonic saline vs rhDNase with | no estimate extracted | 1 study · 47 participants | Very low Downgraded: imprecision, indirectness |
LCI Hypertonic saline vs rhDNase with | no estimate extracted | NR | No studies |
Mortality Hypertonic saline vs rhDNase with | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline vs rhDNase with | no estimate extracted | NR | No studies |
Pulmonary exacerbations Hypertonic saline vs rhDNase with | no estimate extracted | 1 study · 47 participants | Very low Downgraded: imprecision, indirectness |
Adverse events Hypertonic saline vs rhDNase with | no estimate extracted | 1 study · 47 participants | Very low Downgraded: imprecision, indirectness |
Hypertonic saline compared with amiloride for cystic fibrosis
Population: adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1: change from baseline, short‐term Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
FEV1: change from baseline, long‐term Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
LCI Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
Mortality Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline vs amiloride | no estimate extracted | 1 study · 12 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pulmonary exacerbations Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
Adverse events Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
Hypertonic saline compared with sodium‐2‐mercaptoethane sulphonate (Mistabron®) for cystic fibrosis
Population: adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1: short‐term Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | NR | No studies |
FEV1: long‐term Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | NR | No studies |
LCI Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | NR | No studies |
Mortality Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pulmonary exacerbations Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Hypertonic saline compared with mannitol for cystic fibrosis
Population: adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1: short‐term Hypertonic saline vs mannitol | no estimate extracted | 1 study · 12 participants | Very low Downgraded: risk of bias, indirectness |
FEV1: long‐term Hypertonic saline vs mannitol | no estimate extracted | NR | No studies |
LCI Hypertonic saline vs mannitol | no estimate extracted | NR | No studies |
Mortality Hypertonic saline vs mannitol | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline vs mannitol | no estimate extracted | 1 study · 12 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pulmonary exacerbations Hypertonic saline vs mannitol | no estimate extracted | NR | No studies |
Adverse events Hypertonic saline vs mannitol | no estimate extracted | 1 study · 12 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Hypertonic saline 7% versus xylitol for cystic fibrosis
Population: adults with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 (% predicted) change from baseline, short‐term Hypertonic saline 7% vs xylitol | no estimate extracted | 2 studies · 89 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
FEV1 (% predicted) change from baseline, long‐term Hypertonic saline 7% vs xylitol | no estimate extracted | NR | No studies |
LCI Hypertonic saline 7% vs xylitol | no estimate extracted | NR | No studies |
Mortality Hypertonic saline 7% vs xylitol | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline 7% vs xylitol | no estimate extracted | NR | No studies |
Pulmonary exacerbations Hypertonic saline 7% vs xylitol | no estimate extracted | 1 study · 59 participants | Low Downgraded: imprecision, indirectness |
Adverse events: serious adverse events Hypertonic saline 7% vs xylitol | no estimate extracted | 2 studies · 89 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Hypertonic saline 7% versus hypertonic saline 3% for cystic fibrosis
Population: children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 (% predicted) change from baseline, short‐term Hypertonic saline 7% vs hypertonic saline 3% | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
FEV1 (% predicted) change from baseline, long‐term Hypertonic saline 7% vs hypertonic saline 3% | no estimate extracted | NR | No studies |
LCI Hypertonic saline 7% vs hypertonic saline 3% | no estimate extracted | NR | No studies |
Mortality Hypertonic saline 7% vs hypertonic saline 3% | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline 7% vs hypertonic saline 3% | no estimate extracted | NR | No studies |
Pulmonary exacerbations Hypertonic saline 7% vs hypertonic saline 3% | no estimate extracted | NR | No studies |
Adverse events Hypertonic saline 7% vs hypertonic saline 3% | no estimate extracted | NR | No studies |
Hypertonic saline 3% to 7% versus isotonic saline for cystic fibrosis (stable lung disease)
Population: adults and children with cystic fibrosis (stable lung disease)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 (% predicted) change from baseline, short term Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 3 studies · 225 participants | Very 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 extracted | 1 study · 134 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
LCI Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 1 study · 10 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Mortality Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 4 studies · 80 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Pulmonary exacerbations Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 2 studies · 415 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Adverse events Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 6 studies · 589 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, 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)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 (% predicted) change from baseline, short term Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 1 study · 132 participants | Low Downgraded: risk of bias, imprecision, indirectness |
FEV1 (% predicted) change from baseline, long term Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | NR | No studies |
LCI Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | NR | No studies |
Mortality Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 2 studies · 142 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Measures of sputum clearance Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | NR | No studies |
Pulmonary exacerbations Hypertonic saline 3% to 7% vs isotonic saline | HR 0.86 [0.57, 1.3] | 1 study · 132 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Hypertonic saline 3% to 7% vs isotonic saline | no estimate extracted | 2 studies · 142 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Hypertonic saline compared with rhDNase with for cystic fibrosis
Population: adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1 (% predicted) change from baseline, short term Hypertonic saline vs rhDNase with | no estimate extracted | 1 study · 14 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
FEV1 (% predicted) change from baseline, long term Hypertonic saline vs rhDNase with | no estimate extracted | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
LCI Hypertonic saline vs rhDNase with | no estimate extracted | NR | No studies |
Mortality Hypertonic saline vs rhDNase with | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline vs rhDNase with | no estimate extracted | NR | No studies |
Pulmonary exacerbations Hypertonic saline vs rhDNase with | no estimate extracted | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Hypertonic saline vs rhDNase with | no estimate extracted | 1 study · 47 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Hypertonic saline compared with amiloride for cystic fibrosis
Population: adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1: change from baseline, short term Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
FEV1: change from baseline, long term Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
LCI Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
Mortality Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline vs amiloride | no estimate extracted | 1 study · 12 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pulmonary exacerbations Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
Adverse events Hypertonic saline vs amiloride | no estimate extracted | NR | No studies |
Hypertonic saline compared with sodium‐2‐mercaptoethane sulphonate (Mistabron®) for cystic fibrosis
Population: adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1: short term Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | NR | No studies |
FEV1: long term Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | NR | No studies |
LCI Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | NR | No studies |
Mortality Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pulmonary exacerbations Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Hypertonic saline vs sodium‐2‐mercaptoethane sulphonate (Mistabron®) | no estimate extracted | 1 study · 29 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Hypertonic saline compared with mannitol for cystic fibrosis
Population: adults and children with cystic fibrosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
FEV1: short term Hypertonic saline vs mannitol | no estimate extracted | 1 study · 12 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
FEV1: long term Hypertonic saline vs mannitol | no estimate extracted | NR | No studies |
LCI Hypertonic saline vs mannitol | no estimate extracted | NR | No studies |
Mortality Hypertonic saline vs mannitol | no estimate extracted | NR | No studies |
Measures of sputum clearance Hypertonic saline vs mannitol | no estimate extracted | 1 study · 12 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Pulmonary exacerbations Hypertonic saline vs mannitol | no estimate extracted | NR | No studies |
Adverse events Hypertonic saline vs mannitol | no estimate extracted | 1 study · 12 participants | Very low Downgraded: risk of bias, imprecision, indirectness |