Randomised crossover trial of salbutamol aerosol delivered by metered dose inhaler, jet nebuliser, and ultrasonic nebuliser in chronic lung disease

摘要

AIMS—To compare the efficacy of salbutamoldelivered by metered dose inhaler (MDI), jet nebuliser, and ultrasonicnebuliser in ventilated infants with chronic lung disease.
METHODS—Twenty preterm ventilated infants withchronic lung disease were enrolled in two studies. In study 1 (n=10),each infant was given 200 µg of salbutamol at 4 hour intervals and inrandom sequence from a metered dose inhaler-spacer device, a jetnebuliser, and an ultrasonic nebuliser with a small medication cup. Theinfants were monitored for heart rate, transcutaneous pO2,pCO2, and oxygen saturation, respiratory system resistanceand compliance before and after each treatment. Infants in study 2 (n=10) were similarly studied except for the use of a different jet nebuliser.
RESULTS—The mean (SEM) maximum percentagedecreases in respiratory system resistance, observed at 30 minutesafter aerosol delivery were study 1: MDI: 44.3 (4.3)% ; jet: 32.3 (3.4)% ; ultrasonic: 56.1 (3.2)% ; study 2: MDI: 28.6 (1.0)% ; jet:16.9 (1.4)% ; ultrasonic: 42.1 (1.6)%. During the first hour aftertreatment, a significantly faster heart rate and higher transcutaneouspO2 were associated with the use of the ultrasonicnebuliser or MDI than with the jet nebulisers in both studies. The useof the ultrasonic nebuliser but not the other devices also resulted ina lower transcutaneous pCO2 and improved respiratory systemcompliance in study 2.
CONCLUSIONS—These findings suggest thatamong the devices tested, the delivery of salbutamol aerosol to thelower respiratory tract was greatest using the ultrasonic nebuliser,and least with the jet nebulisers.