Nasopharyngeal lavages with saline solutions in the prevention and treatment of upper respiratory tract infections

Nasopharyngeal lavages with saline solutions in the prevention and treatment of upper respiratory tract infections. Could these methods also help in preventing and treating COVID-19?

Nasopharyngeal lavages with saline solutions in the prevention and treatment of upper respiratory tract infections. Could these methods also help in preventing and treating COVID-19??

Sheetu Singh, Neeraj Sharma, Udaiveer Singh, Tejraj Singh, Daya Krishan Mangal, Virendra Singh

The SARS-CoV-2 virus enters the human body either through the mouth, nose or eyes. Similar to hand washing, washing the nose and mouth can reduce viral load, transmission, intensity of symptoms, but also the duration of the disease. Reducing the viral load by gargling and nasal washing with hypertonic saline solutions, can lead to limiting the transmission of the virus to close contacts and subsequently prevent nasopharyngeal viral infections.

Japan was the second country affected by the coronavirus pandemic, after China. However, to the present day, it has a rather low infection and death rate, compared to most countries. Social distancing, protective mask and hand washing are the most important measures to stop the spread of the virus. In Japan, in addition to these measures, the gargle with warm saline solution for cleaning the throat was also included in the epidemic management guide.

The authors analysed eight studies that tested the effectiveness of gargling and nasal washes in treating and preventing acute upper respiratory tract infections (URTI). One of the hypotheses of scientists is that the above techniques can also work in the prevention and care of subgroups of patients with COVID-19.

Methods

The eight controlled studies compared treatment with nasal saline / gargling / steam inhalation with at least one other treatment method or placebo. The subjects were either children, adults or healthy elderly people, or groups suffering from various acute upper respiratory tract infections (rhinitis, rhinosinusitis, sinusitis, pharyngitis, otitis media, tonsillitis, common cold and flu).

Limitations and adverse effects

No adverse effects were observed in subjects who performed nasal washes and gargling with hypertonic saline solutions. A limitation of these treatments was the discomfort felt by the subjects, however, 87% of people endured the procedures.

Another disadvantage would be the possible transmission of viral infection through the equipment used and the area where the procedure is performed. This limitation could be easily solved, by maintaining strict rules-each person uses his/her own equipment, and the sink in which the procedure is performed must be cleaned afterwards.

Conclusions

Studies that tested the effectiveness of gargling and nasal washes with hypertonic saline solutions have shown that these procedures prevent symptoms, reduce transmission, reduce the need for symptomatic medication and viral load in patients with common colds.

However, the usefulness of treatment should be studied specifically in the case of SARS-CoV-2, which has significant mutations compared to coronaviruses causing the common cold or flu. But since it’s proven to work for a multitude of viruses, logically, it should work for SARS-CoV-2 as well. Alternative therapy with saline solutions should be studied as an additional, affordable way to prevent infection and reduce the transmission of the SARS-CoV-2 virus.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353928/

Inhalation of saline solutions reduces exhaled bioaerosols

Inhalation of saline solutions reduces exhaled bioaerosols

David A. Edwards, Jonathan C. Man, Peter Brand, Jeffrey P. Katstra, K. Sommerer, Howard A. Stone, Edward Nardell, Gerhard Scheuch

People exhale aerosols composed of small droplets of fluid that cover the airways during normal breathing. These exhaled bioaerosols can carry pathogens into the air and thus amplify the spread of certain infectious diseases, such as influenza, tuberculosis and severe acute respiratory syndrome.

The authors hypothesize that by altering the surface properties of the pulmonary airways with an inhaled nontoxic aerosol, the number of expired bioaerosol droplets could be substantially reduced and this would be a simple way to mitigate the spread of infectious diseases by air.

Methods

11 healthy adult volunteers aged 18 to 65 years with normal lung function were selected for participation in this study. Exclusion criteria included a history or evidence of lung disease (e.g., cystic fibrosis, chronic obstructive pulmonary disease, or severe asthma), a history or evidence of cardiovascular disease, or acute / chronic upper or lower respiratory tract infections, pregnancy, or breastfeeding . Each subject performed three clinical visits during the study to measure particle exhalation. During their first visit, subjects were randomly assigned to a treatment group and received an aerosol with either a saline solution or a DPPC / POPG surfactant. After at least a week, the subjects made their second visit. Particle exhalation was measured immediately before and 5 minutes, 30 minutes, 1 hour, 2 hours and 6 hours after inhalation. During the third visit, at least one month after the last treatment, the expiration of the particles was assessed in the absence of treatment. During dosing, each subject received saline aerosol or surfactant from a PARI LC Plus Jet nebulizer (PARI, Starnberg, Germany) connected to a compressed air source at 18 psi (1 psi = 6.89 kPa) (1.24 bar).

Conclusions

At the end of the study, it was established that some human subjects exhale more bioaerosol particles than other individuals during breathing. The first exhale on average more than 500 particles per liter in a 6-hour interval, and the others, less than 500. Of the group of 11 volunteers, six belong to the first category and five to the second.

Another conclusion of the research was that the administration of nebulized isotonic saline in these ”large producers ” individuals reduces the number of expired bioaerosol particles by 72.10 ± 8.19% for up to 6 hours after inhalation.

The authors recommend that the effects of saline solutions to modify the properties of the surface of the pulmonary airways, respectively on the transmission of airborne pathogens, be explored further.

Source: https://www.pnas.org/content/101/50/17383

About treating respiratory diseases with Dr. Catalin Carstoveanu

About treating respiratory diseases with Dr. Catalin Carstoveanu

Original article on sfatulmedicului.ro

Catalin Carstoveanu, primary neonatologist at the “Maria Sklodowska Curie” Children’s Emergency Hospital in Bucharest, in an interview in which he talks about the use of the SaltMed saline inhaler (the only inhaler with constant emission of dry salt particles) in the hospital.

In the hospital, what is the most important condition, in the treatment of which you use SaltMed therapy?

Personally, I was involved in treating three types of patients. One and the most important, with obviously positive results – chronic lung disease in new-borns and infants.

A few words about this disease: it is a chronic lung disease, which is a very disabling one, whose main trigger is mechanical ventilation but which also has other triggers: oxygen administration, atelectrauma, infections, etc.

Mechanical ventilation must be conducted in a certain way, usually volutrauma and barotrauma are serious elements in the progression and triggering of the disease, but with all these preventive measures, chronic pulmonary disease is present.

We have many patients suffering from this disease, some of whom we simply cannot sometimes disconnect from mechanical ventilators due to the severity of chronic lung disease, which means long-term pulmonary ventilation. We have a former premature baby hospitalized with multiple diseases but also with chronic lung disease, which after 8 months we managed to disconnect from the ventilation devices, using SaltMed therapy.

We also have another premature baby with very low birth weight, with chronic lung disease, who was mechanically ventilated very gently, who received a very small oxygen fraction during mechanical ventilation, but who had a severe maternal-foetal infection and who now has a severe chronic illness. From the first minutes of the SaltMed administration, we managed to obtain a Tidal Expiratory Volume 20% higher and a saturation 2-3% higher at the same mechanical ventilation parameters.