Inhaled hyperosmolar agents for bronchiectasis

The Cochrane Database of Systematic Reviews
P Wills, M Greenstone

Abstract

Mucus retention in the lungs is a prominent feature of bronchiectasis. The stagnant mucus becomes chronically colonised with bacteria, which elicit a host neutrophilic response. This fails to eliminate the bacteria, and the large concentration of host-derived protease may contribute to the airway damage. The sensation of retained mucus is itself a cause of suffering, and the failure to maintain airway sterility probably contributes to the frequent respiratory infections experienced by many patients. Hypertonic saline inhalation is known to accelerate tracheobronchial clearance in many conditions, probably by inducing a liquid flux into the airway surface, which alters mucus rheology in a way favourable to mucociliary clearance. Inhaled dry powder mannitol has a similar effect. Such agents are an attractive approach to the problem of mucostasis, and deserve further clinical evaluation. To determine whether inhaled hyperosmolar substances are efficacious in the treatment of bronchiectasis The Cochrane Airways Group Specialised Register was searched, and leaders in the field were contacted. Searches were current as of October 2005. Search updates will be run annually. Any trial using hyperosmolar inhalation in patients with bronch...Continue Reading

Citations

Mar 6, 2007·Archives of Disease in Childhood·Beth Enderby, Iolo Doull
May 10, 2012·Mediators of Inflammation·R Masekela, R J Green
Feb 10, 2018·The Cochrane Database of Systematic Reviews·Sarah J NevittTiffany Dwyer
Oct 10, 2015·The Cochrane Database of Systematic Reviews·Sarah J NolanTiffany Dwyer
May 13, 2014·The Cochrane Database of Systematic Reviews·Anna HartIain Crossingham
Nov 1, 2001·The Cochrane Database of Systematic Reviews·T LassersonM Greenstone
May 22, 2008·Clinical Reviews in Allergy & Immunology·Shruti M Paranjape, Pamela L Zeitlin

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