The safety of oxygen‐driven nebulisers in patients with chronic hypoxaemia and hypercapnia

Abstract

ABSTRACTThere is potential to cause deterioration due to hypoxia in patients with acute exacerbation of obstructive airways disease with the indiscriminate use of aerosol bronchodilators delivered by air‐driven nebulisers without supplemental oxygen. Traditionally, air‐driven nebulisers have been reserved for the treatment of chronically hypoxic and hypercapnic patients with an exacerbation of chronic obstructive pulmonary disease (COPD). The purpose of this pilot study was to assess the safety of oxygen‐driven nebulisers (6 L/min) in the treatment of COPD patients.Sixteen patients received bronchodilator via an oxygen‐driven nebuliser for 30 minutes. No patient deteriorated clinically and in all the PaO2 rose significantly (mean baseline 43.7 ± 6.3 mmHg (± SD) post nebuliser 108.8 ± 30.4 mmHg). There was an insignificant rise in PaC02 from 59.7 ± 9.1 mmHg to 66.4 ± 15.3 mmHg and this was not important clinically.On the basis of this pilot study, we suggest that aerosol bronchodilators may be safely delivered by oxygen‐driven nebulisers in chronically hypoxic and hypercapnic COPD patients. A larger scale formal trial is indicated to compare oxygen‐driven versus air‐driven nebulisers in COPD.