Randomized controlled trial of a breath-activated nebulizer in patients with exacerbation of COPD.
Abstract
BACKGROUND
Exacerbations of COPD (ECOPD) are characterized by increased dyspnea due to dynamic pulmonary hyperinflation. This study sought
to determine whether the AeroEclipse II breath-activated nebulizer (BAN) would produce greater bronchodilator responses than
a continuous flow small-volume nebulizer (SVN) in patients with ECOPD.
METHODS
Prospective randomized controlled trial. Forty patients with ECOPD were recruited to participate in the trial. The primary
study outcomes were inspiratory capacity (IC) and dyspnea via the Borg scale. Subjects were randomized to receive bronchodilator
from either a BAN or a continuous flow SVN. Subjects in both groups received 2.5 mg albuterol sulfate and 0.5 mg ipratropium
bromide by nebulizer every 4 hours, and 2.5 mg albuterol every 2 hours as needed. Approximately 2 hours after the subject's
6th scheduled nebulizer treatment, IC, dyspnea, and respiratory frequency measurements were repeated.
RESULTS
Both groups received an equal number of nebulizer treatments over the study period (BAN 6.25 ± 0.55, control 6.2 ± 0.7, P
= .80). Following completion of the study protocol the BAN group had a higher IC than the SVN group (1.83 ± 0.65 L vs 1.42
± 0.49 L, P = .03, respectively). The change in IC was higher in the BAN group (0.33 ± 0.31 L than in the SVN group (0.15
± 0.19 L, P = .03). The BAN group also had a lower respiratory rate (19 ± 3.3 breaths/min vs 22 ± 5.3 breaths/min, P = .03,
respectively). There was no difference in resting dyspnea as measured with the Borg scale (BAN 3.3 ± 2.1, SVN 3.5 ± 2.4, P
= .69) or stay (BAN 4.6 ± 2.6 d, SVN 5.7 ± 2.8 d, P = .21).
CONCLUSIONS
In this cohort of patients with ECOPD, a BAN was more effective in reducing lung hyperinflation and respiratory frequency
than a continuous-flow SVN.
Links
Authors
Institution
Department of Respiratory Therapy, St Joseph Hospital, Nashua, New Hampshire 03060, USA. jhaynes@sjhnh.org
Source
Respiratory care 57:9 2012 Sep pg 1385-90MeSH
AgedAged, 80 and over
Albuterol
Bronchodilator Agents
Dyspnea
Female
Humans
Inspiratory Capacity
Ipratropium
Male
Middle Aged
Nebulizers and Vaporizers
Pulmonary Disease, Chronic Obstructive
Respiratory Rate
Pub Type(s)
Journal ArticleRandomized Controlled Trial
Language
eng
PubMed ID
22348309
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