Effects of nebulizer fill volume on the efficacy and safety of the bronchodilator

Abstract

This study aimed to demonstrate the effect of adding saline to the respirable-solution of salbutamol placed in a nebulization chamber on the clinical status of the ventilated patient.A total of 160 (80 female) asthmatic subjects were randomly divided into 8 groups (gp1-gp8). They received 0.5 ml salbutamol respirable-solution (5000 μg\\ml), 0.5 ml salbutamol respirable-solution+1 ml saline, 0.5 ml salbutamol respirable-solution+2 ml saline, 0.5 ml salbutamol respirable-solution+3 ml saline, 1 ml salbutamol respirable-solution, 1 ml salbutamol respirable-solution+1 ml saline, 1 ml salbutamol respirable-solution+2 ml saline and 1 ml salbutamol respirable-solution+3 ml saline respectively using jet-nebulizer. Forced expiratory volume in 1 s as a percentage of predicted (FEV1%), oxygen-saturation, pulse-rate, and respiratory-rate were measured before and 10–20 min after the nebulization of the salbutamol.0.5 ml salbutamol respirable-solution had no significant improvement in FEV1%. However, 1 ml had a significant improvement in FEV1% (p < 0.001). Increasing fill volume increased the FEV1% significantly (p < 0.001). No significant difference in FEV1% when saline increased from 2 ml to 3 ml. There was no significant difference in oxygen-saturation before and after the administration of salbutamol. Pulse-rate increased significantly (p < 0.01) at higher fill-volumes especially in group 6–8. A few subjects complained of palpitation and headache at the end of nebulization.Increasing fill-volume with jet-nebulizer enhanced the bronchodilator effect of salbutamol and plateau occurs after 2 ml added saline.