Abstract
Objective: The bronchodilator test is a useful method for measuring the changes in lung capacity with spirometry after inhaling a short-acting bronchodilator drug to diagnose patients with obstructive lung disease. Although its liquid form was available, the inhaler form of levosalbutamol is a relatively new short-acting bronchodilator. To measure the efficacy of levosalbutamol in acute bronchodilator reversibility, in this study, we aimed to compare the effects of salbutamol and new levosalbutamol/ipratropium combination on early reversibility and FEV1 changes observed in bronchodilator tests.
 Methods: Bronchodilator test results of forty-two patients who were selected according to the inclusion criteria were retrospectively analyzed. The results of spirometry analysis were evaluated for twenty-four patients who received salbutamol (Group I) and eighteen patients who received levosalbutamol/ipratropium combination (Group II). Reversibility levels were evaluated as the absolute and percentage changes in FEV1.
 Results: The changes of absolute and percentage values of mean FEV1 were 159±118 mL, 12.2%±11.4% in salbutamol (Group I) group and 233±191mL, 18.8%±15.6% in levosalbutamol / ipratropium (Group II) combination (p=0.025 and 0.048, respectively). Although no significant difference was observed in the reversibility results, Group II showed significantly improved FEV1 values compared to Group I.
 Conclusion: To the authors’ knowledge, this is the first study demonstrating that the combination of inhalation therapy with levosalbutamol and ipratropium bromide is more beneficial than salbutamol alone in terms of FEV1 improvement in bronchodilator test. We suggest that this combination can be a good candidate for utilization in diagnostic bronchodilator tests since it proved a specific higher improvement in FEV1 values.
Highlights
To the authors’ knowledge, this is the first study demonstrating that the combination of inhalation therapy with levosalbutamol and ipratropium bromide is more beneficial than salbutamol alone in terms of FEV1 improvement in bronchodilator test. We suggest that this combination can be a good candidate for utilization in diagnostic bronchodilator tests since it proved a specific higher improvement in FEV1 values
Obstructive lung diseases such as asthma, chronic bronchitis, and emphysema are the most common pulmonary diseases worldwide which are characterized by chronic airway inflammation and airway obstruction
Assessment with spirometry helps making a diagnosis by differentiating between obstructive lung diseases, such as asthma or chronic obstructive pulmonary disease (COPD), and restrictive lung disorders, such as interstitial pneumonia [2]
Summary
Obstructive lung diseases such as asthma, chronic bronchitis, and emphysema are the most common pulmonary diseases worldwide which are characterized by chronic airway inflammation and airway obstruction. They are characterized by reduced airflow related to airway narrowing which was caused by an increased airway resistance [1]. Fixed or non-reversible airway obstruction that is characteristic of COPD complicates the differential diagnosis by spirometry alone. Airway obstruction is not fully reversible in such patients, bronchodilator responsiveness is common and bronchodilator medications are used both for diagnosis and management [3]. American Thoracic Society recommends using a short-acting β2adrenoceptor agonist, such as salbutamol, or an anticholinergic, such as ipratropium bromide, for reversibility testing [5]
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