The timing of hypertonic saline (HTS) and airway clearance techniques (ACT) in adults with Cystic Fibrosis (CF) during pulmonary exacerbation: Pilot data form a randomised crossover study.

Background: Streamlining the timing of treatments in Cystic Fibrosis (CF) is important to optimise adherence whilst ensuring efficacy. The optimal timing of treatment with hypertonic saline (HTS) and airway clearance techniques (ACT) is unknown.Objectives: This study hypothesised that HTS before ACT would be more effective than HTS during ACT as measured by lung clearance index (LCI). Methods: Adults with CF providing written informed consent were randomised to a crossover trial of HTS before ACT or HTS during ACT on consecutive days. ACT treatment consisted of Acapella® Duet. Patients completed LCI and spirometry at baseline and 90 mins post treatment. Sputum was collected immediately post treatment. Patient perception of ease of clearance and satisfaction with treatment was recorded. Wilcoxon test was used and p