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Clinical Results

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HALOTHERAPY FOR TREATMENT OF RESPIRATORY DISEASES


ALINA V. CHERVINSKAYA and NORA A. ZILBER

Saint-Petersburg Pavlov National Medical University, Russia
Joint- Stock Company Aero med, Saint-Petersburg, Russia

ABSTRACT

This work elucidates the questions upon the development of a new drug-free method for respiratory diseases treatment. Halotherapy (HT) - is a mode of treatments in a controlled air medium which simulates a natural salt cave microclimate. The main curative factor is the dry sodium chloride aerosol with particles of 2 to 5 mkm in size. Particles density (0.5-9 mg/m³) varies with the type of the disease. Other factors are: comfortable temperature, humidity regime, the hypo bacterial and allergen- free air environment saturated with the aerosol.

The effect of HT was evaluated in 124 patients (pts) with various types of respiratory diseases. The control group of 15 pts received placebo. HT course consisted of 10-20 daily procedures of 1 hour. HT resulted in improvements of clinical state in the most of the patients. The positive dynamics of flow-volume loop parameters and decrease of bronchial resistance measured by bodyplethysmography were observed. The changes in the control group parameters after HT were not statistically significant. The specificity of this method is the low concentration and gradual administration of dry sodium chloride aerosol. Data on healing mechanisms of a specific air dispersive environment of sodium chloride while treating the respiratory diseases are discussed.

INTRODUCTION

 

The considerable increase of allergic diseases and reactions and of other serious complications due to the drug therapy explains the interest of clinicians to the development of drug-free methods of treatment. Halotherapy ("halos" in Greek means salt) is one of such methods. Halotherapy (HT) is a mode of treatments in a controlled air medium which simulates a natural salt cave microclimate.

The treatment in the natural salt caves (Speleotherapy) has been known since long. The efficacy of Speleotherapy is associated with the unique cave microclimate. The natural dry sodium chloride aerosol is the major curative factor of the cave microclimate. It is formed by the convective diffusion from salt walls. Other factors such as comfortable temperature and humidity regime, the hypo bacterial and allergen-free air environment saturated with aero ions enhance the therapeutic effect.

A suggestion that it is the air saturated with saline dust that causes the main curative effect in the Speleotherapy of patients with respiratory diseases was first formulated by a Polish physician F.Bochkowsky in 1843. Salt mines are known to be used for therapeutic purposes in other countries such as Austria (Solzbad-Salzetnan), Rumania (Sieged), Poland (Wieliczka), Azerbaijan (Nakhichevan), Kirgizia (Chon-Tous), Russia (Berezniki, Perm region), the Ukraine (Solotvino, Carpathians), Artiomovsk, Donietsk region).

Speleotherapy has been recognized as a highly effective drug-free treatment method. Great experience in the treatment of patients with various forms of chronic nonspecific pulmonary diseases has proved Speleotherapy to be very effective under the conditions of the salt mine microclimate of Solotvino. The therapeutic effect has been proved by the data of biochemical immunological and microbiological research (Simyonka 1989, Slivko, 1980, Yefimova et al, 1990, Zadorozhnaya et al, 1986). It is assumed that during the treatment the organism adapts to the specific features of the microclimate and alters all its functional systems.

However, adaptation of the patients who came from different climate areas, travel and transport problems, and limited number of beds kept back its wide spreading. So HT has been worked out.

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Saline nasal irrigation

Its role as an adjunct treatment
Blake Papsin, MD, FRCSC Alison McTavish, MSC

ABSTRACT

OBJECTIVE To review clinical evidence on the efficacy of saline nasal irrigation for treatment of sinonasal conditions and to explore its potential benefits.

QUALITY OF EVIDENCE Clinical trials, reviews, and treatment guidelines discussing nasal irrigation were obtained through a MEDLINE search from January 1980 to December 2001. Most trials were small, and some were not controlled; evidence, therefore, is level II, or fair.

MAIN MESSAGE Flushing the nasal cavity with saline solution promotes mucociliary clearance by moisturizing the nasal cavity and by removing encrusted material. The procedure has been used safely for both adults and children, and has no documented serious adverse effects. Patients treated with nasal irrigation rely less on other medications and make fewer visits to physicians. Treatment guidelines in both Canada and the United States now advocate use of nasal irrigation for all causes of rhinosinusitis and for postoperative cleaning of the nasal cavity.

CONCLUSION Nasal irrigation is a simple, inexpensive treatment that relieves the symptoms of a variety of sinus and nasal conditions, reduces use of medical resources, and could help minimize antibiotic resistance.

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Nebulized hypertonic saline solution for acute bronchiolitis in infants

Linjie Zhang1, Raúl A Mendoza-Sassi2, Claire Wainwright3, Terry P Klassen4
1Department of Maternal and Child Health, Federal University of Rio Grande, Rio Grande, RS, Brazil. 2Department of Internal Medicine, Federal University of Rio Grande, Rio Grande, RS, Brazil. 3Department of Respiratory Medicine, Royal Children’s Hospital, Brisbane, Australia. 4Department of Pediatrics, Aberhart Centre One, Room 8213, Edmonton, Canada


ABSTRACT

Background
Airway edema and mucus plugging are the predominant pathological features in infants with acute viral bronchiolitis. Nebulized hypertonic saline solution may reduce these pathological changes and decrease airway obstruction.

Objectives
To assess the effects of nebulized hypertonic saline solution in infants with acute viral bronchiolitis.

Search strategy
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, issue 4), which contains the Cochrane Acute Respiratory Infections Group Specialized Register; OLDMEDLINE (1951 to 1965); MEDLINE (1966 to November 2007); EMBASE (1974 to November 2007); and LILACS (November 2007).

Selection criteria
Randomised controlled trials (RCTs) and quasi-RCTs using nebulized hypertonic saline alone or in conjunction with bronchodilators as an active intervention in infants up to 24 months of age with acute bronchiolitis.

Data collection and analysis
Two review authors (ZL, MRA) independently performed data extraction and study quality assessment. We pooled the data from individual trials using the Cochrane statistical package Review Manager (RevMan).

Main results
We included four trials involving 254 infants with acute viral bronchiolitis (189 inpatients and 65 outpatients) in this review.
Patients treated with nebulized 3% saline had a significantly shorter mean length of hospital stay compared to those treated with nebulized 0.9% saline (mean difference (MD) -0.94 days, 95% CI -1.48 to -0.40, P = 0.0006).
The 3% saline group also had a significant lower post-inhalation clinical score than the 0.9% saline group in the first three days of treatment (day 1: MD -0.75, 95% CI -1.38 to -0.12, P = 0.02; day 2: MD -1.18, 95% CI -1.97 to -0.39, P = 0.003; day 3: MD -1.28, 95% CI -2.57 to 0.00, P = 0.05). The effect of nebulized hypertonic saline in improving clinical score was greater among outpatients than inpatients. No adverse events related to 3% saline inhalation were reported.

Authors’ conclusions
Current evidence suggests nebulized 3% saline may significantly reduce the length of hospital stay and improve the clinical severity score in infants with acute viral bronchiolitis.

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