Nebuliser & Saline recommendations guidance (Bronchiectasis)

[Yess1e]

Hi, can anyone recommend a nebuliser, ideally one that's reasonably portable. I've been waiting for one for over 2yrs now so I've given up and will have to buy one myself. I understand I can use 0.9% hypertonic solution without concern?

I've literally no idea how to use one, in terms of what to put where and the little vials of solution, do you add water too?

Would appreciate any thoughts and guidance.

Thank you so much.

[Ozzie3]

I use nebulised saline twice a day and it clears my lungs of mucous so that I never cough during the day or night. 0.9% saline is just ‘normal’ saline, I.e. the concentration of salt in the blood. I use 6% or 7% saline which is ‘hypertonic’ saline. Hypertonic saline draws water into the bronchi (lung tubes) by osmosis moistening the mucous so it is easy to cough. It also stops bacteria growing and moving (that’s why we pickle food in salt water to preserve it). After using it for a month the results of my lung function tests improved markedly. My specialist says the best way to treat bronchiectasis is to keep your lungs ‘dry’ (free of mucous). This prevents infections and further damage.

I have tried a number of nebulisers. I find the ‘Philips InnoSpire Go’ the best. It takes enough saline is fast and silent and very portable. You get 30 uses from one battery charge. There is only one part to clean and sterilise.

You can buy hypertonic saline online as either 6% or 7% in either 4ml or 5ml single use vials. Common brands are Pari (Mucoclear) and Salineb. The one I find the best is the one made by Base Laboratories- it is 5mls of 7% saline.

I clean the head of my Innnospire Go in warm water with a drop of dishwashing liquid. I sterilise it in Babybrezza sanitiser and dryer. I use this with distilled water to avoid scale forming on the heating disc.

After inhaling the hypertonic saline I try not to cough for 10 minutes to give the salt water time to soften the mucous in my lungs. I then do huffing and effortlessly cough up the sputum together with a bit of fluid that has mixed with it.

The only problem with the InnoSpire Go, which it has in common with all portable mesh nebulisers, is that the breath that comes out of the two holes at the back of the head condenses into liquid which runs down the handle at the back. I fold three tissues into a small rectangle and hold it just below the holes to catch this fluid.

The salt water can tickle your throat and make your mouth taste very salty. Just push the button on the InnoSpire Go to pause it and put it down and wash your mouth out before continuing your treatment. The InnoSpire Go makes a beep when all the saline is finished (it’s the only nebulise which doesn’t leave any residual saline).

Using nebulised hypertonic saline has been a game changer for me. Everyone is different but I know many people who have bronchiectasis have had the same positive experience and there are research papers to back it up.

I am happy to answer any questions you may have.

[Tinker26 in reply to Ozzie3]

I was given mine from the respiratory team and given a trial of use first at my local hospital ,mines called an ombra and i nebulise hypertonic saline,physiotherapist assessed my use as can cause bronchospasm so speak to repiratory team first ...good luck

[Yess1e in reply to Tinker26]

Hi, that's why I thought I'd have to use the 0.9% as the respiratory physio has been pretty awful, she booked me in for an assessment and then totally forgot it was for that, such a waste of time. Now she's saying she needs the consultant to ok it. The consultant said speak to physio. Do you know what nebuliser model you have, is it portable? Tinker26?

[Tinker26 in reply to Yess1e]

Yes it's an omron portable nebuliser, I've taken it on holiday as it comes with a carry case x

[Dottie11 in reply to Ozzie3]

Thank you. I too have to buy my own. Waiting time unknown by NHS. Very helpful

[Yess1e in reply to Dottie11]

I had the assessment booked in and the physio hadn't done it, despite it being reason behind a long wait between appointments. I'm glad I check as it's a 4hr round trip.Have you a model in mind?

[Dottie11 in reply to Yess1e]

I am still wondering which one. So confusing. Yes good job you found out. Good luck

[Phill1 in reply to Ozzie3]

that nebulous set looks really good & I’m supposed to be starting on nebulised colomycin sometime soon

Do you know / does anyone know whether that is compatible with the Innospire ????🤞

[Ozzie3 in reply to Phill1]

No you can't. For an antibiotic you need a nebuliser that does not allow any antibiotic to escape into the air. Either something like the Pari LC jet nebuliser with an attached filter set or a breath-activated nebuliser like the I-Neb. With the InnoSpire Go the antibiotic would escape into the air, giving you a lower dose than you require and having the risk of other people in the environment breathing in your antibiotic. The doctor who prescribed the antibiotic shold know this.

[Yess1e in reply to Ozzie3]

Thank you for all that useful info Ozzie, did you have an assessment to use the hypertonic saline? I had one booked but the physio seems somewhat rubbish and has totally forgotten. I thought I could start with the 0.9% on my own without assessment as my body tends to over react to everything anyway. Even moisture build up when wearing a mask seems to help move mucus. It just feels a bit daunting buying it all with no guidance from anyone.

Though all your info has been really helpful, so thank you.

[Ozzie3]

No, I didn’t have an assessment. My respiratory physician told me what to get and I started using it at home. Fortunately I haven’t had any problems.. Remember it’s only salt water. It does make your mouth taste salty and tickles you throat. Every now and again I stop, wash out my mouth with water and do a little gargle with water and the start again. If it was something like nebulised gentamicin, I would have had a test dose but not for hypertonic saline. But as you point out some people are more sensitive than others.

[Ozzie3 in reply to Ozzie3]

BTW they give 3% nebulised hypertonic saline to babies with respiratory syncytial virus infections - so I reckon if they can take it, an adult should manage the 6 or 7% solution

[Yess1e in reply to Ozzie3]

Ah ok. They keep making it sound dangerous and that it's essential I have an assessment...but then not booking it in. I've asked if a nebuliser would help for over two years! They said it wouldn't initially. I might just try it myself, with the baby 3% amount.

[Ozzie3]

Good idea. The fact that 3%, 6%, and 7% are all available without a prescription should make you feel comfortable. Don't be put off if it feels a bit irritating or salty. Just stop, take a break, rinse your mouth and when you feel comfortable continue. Try not to cough because you will just cough up the salt water before it has a chance to work. You may feel the phlegm in your chest but give it a little while to work before huffing and coughing 5 or 10 minutes after all the salt is finished. Good Luck! Please let me know how you go.

[Ozzie3 in reply to Ozzie3]

PS Make certain you get the salt solution for nebuliser in little ampules - not the one for injection in ampules which contains preservatives!