Saline Concentration for Nebulization to Assist Expectoration

Standard Protocol

• The British Thoracic Society recommends 0.9% normal saline for nebulization to assist physiotherapy and sputum clearance 1, 2
• A typical volume of 5 mL of 0.9% sodium chloride is administered every 6 hours to loosen tenacious secretions in palliative care settings 3
• For sputum induction procedures, 2.7% hypertonic saline solution in volumes of 20-30 mL is used with high-output ultrasonic nebulizers 3

Critical Safety Consideration

• Water should never be used as a nebulizing solution because it may cause bronchoconstriction when nebulized, as recommended by the British Thoracic Society 1, 2

Administration Details

• Oxygen is the preferred driving gas for nebulization at flow rates of 6-8 L/min, as recommended by the British Thoracic Society 1, 5
• Large volume nebulizer-based humidifiers delivering 0.9% saline can assist with expectoration in patients requiring humidification with high-flow oxygen or those with viscous sputum retention 5