Unbound MEDLINE

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

  • Publisher Full Text
  • Authors

    Haynes JM

    Institution

    Department of Respiratory Therapy, St Joseph Hospital, Nashua, New Hampshire 03060, USA. jhaynes@sjhnh.org

    Source

    Respiratory care 57:9 2012 Sep pg 1385-90

    MeSH

    Aged
    Aged, 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 Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    22348309