In 1973, Dermers and Saklad12 found that normal saline
instillation was not effective in thinning or liquefying
secretions. These authors cite: Bwater in the form of a
vapor or an aerosol is of proven value in thinning
secretions and promoting their clearance, mucus and
water in bulk form are immiscible and occupy separate
phases in vitro, even after vigorous shaking. Endotracheal
instillation and rapid removal by suctioning is therefore
of dubious value.^ In addition, other researchers conducted
a study to compare the distribution of instilled
saline solution with the distribution of inhaled nebulized
solution.13 The researchers studied 9 patients in an
ICU who were treated with volume-controlled, pressure
support-mode mechanical ventilation. Patients were examined
with single photon emission computed tomography.
They found that the instilled fluid only goes to the
posterior portion of the right lower pulmonary lobe.
However, if a nebulized solution was used,