Hypertonic Saline 3-7%
Hypertonic saline is a high-concentration saline solution that helps clear mucus from the lungs of CF patients and is part of the standard of care. The treatment is included in the health basket and is available to patients at the health funds.
Until recently, only one preparation was available in this framework as a solution at a concentration of 6%. This preparation does not contain a buffer (and therefore is not balanced in terms of PH). Measurements made for him revealed an acidic PH (usually 6.5 – as expected following distilled water and salt).
In November 2017, the Ministry of Health issued a Deputy Director-General circular confirming that Hypertonic Saline 3-7% is a drug designed for cystic fibrosis and therefore is subject to an exemption from the deductible.
The issue arose thanks to one of the graduates of the board of directors who passed an admission on the subject and led to the clear ruling of the Ministry of Health on the matter.
שימו לב שהדבר נכון לכל קופות החולים.
PULMOSAL 7% (PH
It contains a saline solution at a concentration of 7% and a buffer that maintains a pH of 7.4, which is the physiological pH of the lung lining.
Beyond the effectiveness in facilitating the clearance of mucus due to the high concentration of salt, the physiological pH does not irritate. Thus, the preparation is more tolerable when used.
Note that the salt concentration in Pulmosal is 7%, and is the usual concentration. The clinical trials that followed the treatment became standard were with saline at this concentration.
In addition, several articles have recently been published in the journals Science and Nature, which have shown that CF patients’ lungs are “sour” from the norm and have demonstrated the link between this acidity and impairment of their protective (antibacterial) activity that can lead to increased pathogenic bacteria.
In the following graphs from one of the articles published in January this year, one can see the relationship between the level of acidity of the fluid in the respiratory tract (ASL) and the number of healthy bacteria in a laboratory animal model.
An in vitro study showed an association between the acidity of the hypertonic saline preparation and the concentration of the pseudomonas eruginosa bacterium. It was found that the attention of the bacterium was more significant in the mucus treated with the trial with acidic pH compared to its engagement with the Pulmosal practice 7% (pH +). This fact may affect the incidence of infections with this bacterium in CF patients.
In light of these properties of Pulmosal (+ Pulmosal 7% pH) we recommend using this preparation. There is currently a problem at some checkouts to get the practice. Therefore, to receive the trial, one should ask the CF doctor for a personal letter saying he recommends giving polemical. Once there is the letter, the cashier must deliver the preparation. We hope that there will be no need for a letter from the doctor within a short period.