In metode saline am inclus procedee preventive complementare eficiente si flexibile care pot sa asigurare un grad de protectie complementar consistent fata de infectii cu transmitere respiratorie. Aceste metode actioneaza asupra sistemului respirator limitand procesele de infectare, reduc procesele de raspandire de la persoanele purtatoare si pot avea si efecte de limitare a severitatii manifestarilor simptomatice. Sunt metode cunoscute si studiate medical, utilizate curent complementar in tratamentele multor probleme respiratorii generale dar si pentru o protectie suplimentara fata de virozele obisnuite in sezonul rece. Datele din studii medicale si de laborator arata potentialul lor foarte valoros in situatia actuala ca importante metode complementare de preventie in infectia COVID-19.
Se pot grupa in doua categorii mari:
- metode cu solutii saline si aerosoli umezi obtinuti din solutii saline
- metode cu aerosoli salini uscati – metode diverse care utilizeaza sarea in stare solida
A. Metode cu solutii si aerosoli umezi
- spalaturi nazale si gargara . Studiu centralizator evaluare [1] realizat de colectiv din Jaipur India. Scadere semnificativa a infectiilor respiratorii. Utilizarea pe scara larga in Japonia posibila explicatie a incidentei scazute COVID in Japonia.
- actiune antivirala sare. Studiu Scotia [2] . Spalaturi nazale si gargara ca metoda de tratament viroze respiratorii. In desfasurare studiu pe pacienti COVID
- nebulizator solutie salina – Pulmatrix USA [3]- ca metoda de preventie in transmiterea virozelor respiratorii prin reducerea cu peste 90% a aerosolilor potential purtatori de virusi. In evaluare ca posibila metoda de control a raspandirii infectiei COVID in colective de risc.
- Studiu Canada – Coreea de sud care arata ca texturi acoperite cu cristale de sare retin virusii din aer iar sarea distruge foarte rapid virusii retinuti
B. Metode cu aerosoli uscati
Tratamente complementare realizate cu aerosoli salini uscati se fac in: saline, camere de sare, cu generatoare mecanice de aerosoli uscati si cu aparatele care folosesc procedeele tehnologice Salin.
Camerele de sare si inhalatoarele mecanice utilizeaza concentratii mari de aerosoli uscati – 10-40 mg/mc- iar expunerea este de durata scurta 45-60 min [6].
Sistemele Salin utilizeaza concentratii de aerosoli salini de peste 200-1000 ori mai mici – 0,03-0,04 mg / mc – iar expunerea este pe durata lunga 8-10 ore pana la permanent fara contraindicatii. [7]
- camerele de sare nu pot fi utilizate in aceasta perioada sau sunmt greu utilizabile datorita restrictiilor de socializare
- inhalatoare cu generare mecanica- studiu Rusia antiviral [8] – expuneri zilnice scurte, de 10 min, cu inhalare individuala aerosoli produsi de un generator mecanic. Grupul de test incidenta de pana la 6 ori mai mica a virozelor respiratorii
- aparatele Salin au efectul constatat inclusiv prin urmarirea directa in ATI de crestere semnificativa a eliminarii secretiilor respiratorii [9]. In grupe de studiu au fost semnalate direct reducerea infectiilor respiratorii sezoniere. Utilizatori individuali au semnalat in numeroase cazuri acest efect de reducere majora a infectiilor respiratorii.
Sistemele Salin au un potential foarte valoros de utilizarie ca un sistem eficient de preventie intr-o modalitate comoda si integrata:
- ambiental cu Dispozitive Saline Artizanale si aparate ambientale sau filtre incluse in sisteme de filtro-ventilatie. Ar asigura o plasa de protectie suplimentara pentru toti cei din spatiul respectiv.
- INSALIN ca dispozitiv individual permanent la indemana cu utilizare periodica in periade de expunere.
- SaltMed ca sistem intensiv de aerosoli uscati pentru toate persoanele in pozitii de risc. Utilizare preventiva la persoane cu afectiuni respiratorii sensibilizante fata de infectiile virale sezoniere ca masura de protectie suplimentara COVID.
Referințe
[1] Nasopharyngeal wash in preventing and treating upper respiratory tract infections: Could it prevent COVID‐19?
- Sheetu Singh1, Neeraj Sharma2, Udaiveer Singh3, Tejraj Singh3, Daya Krishan Mangal2, Virendra Singh4
- Lung India • Volume 37 • Issue 3 • May-June 2020 [Downloaded free from http://www.lungindia.com on Sunday, August 2, 2020]
[2] Antiviral innate immune response in non-myeloid cells is augmented by chloride ions via an increase in intracellular hypochlorous acid levels
- Sandeep Ramalingam 1,2, Baiyi Cai2, Junsheng Wong2, Matthew Twomey2, Rui Chen2, Rebecca M. Fu2, Toby Boote2, Hugh McCaughan1, Samantha J. Griffiths 2 & Jürgen G. Haas1,2
1Department of Laboratory Medicine, NHS Lothian, Edinburgh Royal Infirmary, Edinburgh, UK. 2Division of Infection and Pathway Medicine, University of Edinburgh, Edinburgh, UK. Samantha J. Griffiths and Jürgen G. Haas contributed equally. - SCIENTIFIC REPORTS|(2018) 8:13630 | DOI:10.1038/s41598-018-31936-y
[3] Inhaling to mitigate exhaled bioaerosols
- David A. Edwards*, Jonathan C. Man‡, Peter Brand, Jeffrey P. Katstra‡, K. Sommerer§, Howard A. Stone*, Edward Nardell¶, and Gerhard Scheuch
- Harvard University, 322 Pierce Hall, 29 Oxford Street, Cambridge, MA 02138; ‡Pulmatrix Incorporated, 840 Memorial Drive, Cambridge, MA 02139; Inamed, Wohraer Strasse 37, 35285 Gemuenden Wohra, Germany; and Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115
- 7384 www.pnas.org/cgi/doi/10.1073/pnas.0408159101
[4] Universal and reusable virus deactivation system for respiratory protection
- Fu-Shi Quan1,*, Ilaria Rubino2,*, Su-Hwa Lee3, Brendan Koch2 & Hyo-Jick Choi2
- Department of Medical Zoology, Kyung Hee University School of Medicine, Seoul, 130-701, Korea. 2Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada. 3Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 130-701, Korea. *
- SCIENTIFIC REPORTS | 7:39956 | DOI: 10.1038/srep39956
[6.] Salt caves as simulation of natural environment and significance of halotherapy
- Joanna Zając1, Iwona Bojar2, Jadwiga Helbin1, Emilia Kolarzyk1, Alfred Owoc3
- Department of Hygiene and Dietetics, Jagiellonian University, Medical College, Krakow, Poland
- Department for Health Problems of Ageing, Institute of Rural Health in Lublin, Poland Lubuski College of Public Health, Zielona Góra, Poland
- Lubuski College of Public Health, Zielona Góra, Poland
- Annals of Agricultural and Environmental Medicine 2014, Vol 21, No 1, 124–127 www.aaem.pl
[7] Inhaled dry salt micro particles in the treatment of bronchopulmonary dysplasia: a five case series report
- NINE LUMINITA2, CATALIN G CIRSTOVEANU1, ALEXANDRA I ISTRATE –BARZAN2, BARASCU IL- EANA2, STEFAN MANOLACHE2, MIHAELA BIZUBAC2, ALINA GAIDUCHEVICI2
- 1 “Carol Davila” University of Medicine and Pharmacy, Bucharest Romania 2 ”Marie Curie“ Emergency Hospital for Children, Bucharest, Romania
SIGNA VITAE 2017; 13(2): 85-89
[8] Dry sodium chloride aerosol against acute respiratory infections
- Alina Chervinskaya
- St.Petersburg, Russian Federation
- Poster was presented at the European Respiratory Society (ERS) Annual Congress on 14.09.2009 in Session 206: “Treatment modalities in chest physiotherapy”.
[9] SALTMED – THE THERAPY WITH SODIUM CHLORIDE DRY AEROSOLS
- Autori: Dr. Bogdan Oprita *, Dr. Cristian Pandrea*, Dr. Violeta Nedelcu**, Dr. Bogdan Aiganatoaie***
- Emergency Hospital 8 Calea Floreasca 5tr., Bucharest, Romania
- Therapeutics, Pharmacology and Clinical Toxicology, Vol XIV, Number 3, September 2010 Number 3, pages 201-204