It is strong salt solution given via a nebuliser to help loosen thick phlegm from your lungs.

It works by
thinning the phlegm and making it easier to clear while you do your airway clearance exercise
(breathing/coughing exercises).
The nebuliser is a small machine, which helps to turn the hypertonic salt solution in to a fine mist, so
you can breathe it in easily and it will spread throughout the airways in the lung.

Your doctor has prescribed this to aid with your chest clearance. This is recommended for patients
with thick secretions, who have tried other therapies and still have difficultly clearing phlegm (mucus)
from their chest. Research studies have shown that this therapy may help to reduce the number of
chest infections, and reduce the need for hospital admissions. It has also been shown to improve
quality of life by improving your breathing and helping your lungs to stay healthier for longer.

Serious allergic reactions are rare, but there is a potential risk of developing spasm in your airways,
this may cause chest tightness, wheeze, cough and throat irritation.
To identify this risk, we carry out a test dose trial before starting this therapy; this involves being given
a dose of the hypertonic saline, with breathing tests before and after, to rule out any serious adverse
reactions and also assess your response.
If you didn’t tolerate the test well, we may try a lower strength or give a bronchodilator medicine
(salbutamol) to help you take the inhaled hypertonic saline more easily.

It is very rare for patients to get side effects after passing the test dose trial, but If you experience any
of the following symptoms (chest tightness, wheeze, cough and throat irritation) after taking the
hypertonic saline, stop the inhaled hypertonic saline immediately and contact either your GP,
your respiratory physiotherapist, consultant or nurse for further advice. If you have a salbutamol
inhaler or nebuliser you can take this to help with the symptoms.
If your symptoms are worse and haven’t improved since stopping the hypertonic saline visit your local
A&E or call an ambulance.

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Initially you will use it for three months and if it has helped, then we recommend it to be used
regularly. It needs to taken twice daily and must be followed with airway clearance exercises.

If you develop any side effects or if you notice any side effects not listed in the manufacturer’s leaflet,
please tell your doctor or pharmacist.
Dr Berry can be contacted via his secretary on 020 3312 7942 or via the Chest & Allergy clinic nurses
on 020 3312 1836.
The respiratory physiotherapist can be contacted on 020 3312 2349.
For nebuliser machine related queries, please contact lung function on 020 3312 6022.

We aim to provide the best possible service and staff are happy to answer any questions you may
have. If you were pleased with your care and want to write to let us know we would appreciate your
time in doing so.
However, if your experience of our services does not meet your expectations and you would like to
speak to someone other than staff caring for you, please contact the patient advice and liaison
service (PALS) on 020 3313 0088 for Charing Cross, Hammersmith, and Queen Charlotte’s and
Chelsea Hospitals or 020 3312 7777 for St Mary’s and Western Eye Hospitals. You can also email
PALS at pals@imperial.nhs.uk. The PALS team will listen to your concerns, suggestions or queries
and are often able to solve problems on behalf of patients.
Alternatively, you may wish to express your concerns in writing to:
Chief Executive, Imperial College Healthcare NHS Trust, Trust Headquarters,
The Bays, South Wharf Road, London W2 1NY

This information can be provided on request in large print, as a sound recording, in Braille, or in
alternative languages. Please contact the communications team on 020 3312 5592.

Respiratory medicine
Published: Aug 2014
Review date: Aug 2017
Reference no: 2487v1
© Imperial College Healthcare NHS Trust
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