Randomised crossover trial of salbutamol aerosol delivered by metered dose inhaler, jet nebuliser, and ultrasonic nebuliser in chronic lung disease
Department of Paediatrics, The Chinese University of
Hong Kong, The Prince of Wales Hospital, Shatin, Hong Kong, People's
Republic of China
Correspondence to: Dr T F Fok.
Accepted 4 February 1998
AIMS
To compare the efficacy of salbutamol
delivered by metered dose inhaler (MDI), jet nebuliser, and ultrasonic
nebuliser in ventilated infants with chronic lung disease.
METHODSTwenty preterm ventilated infants with
chronic 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 in
random sequence from a metered dose inhaler-spacer device, a jet
nebuliser, and an ultrasonic nebuliser with a small medication cup. The
infants were monitored for heart rate, transcutaneous pO2,
pCO2, and oxygen saturation, respiratory system resistance
and compliance before and after each treatment. Infants in study 2 (n=10) were similarly studied except for the use of a different jet nebuliser.
RESULTSThe mean (SEM) maximum percentage
decreases in respiratory system resistance, observed at 30 minutes
after 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 after
treatment, a significantly faster heart rate and higher transcutaneous
pO2 were associated with the use of the ultrasonic
nebuliser or MDI than with the jet nebulisers in both studies. The use
of the ultrasonic nebuliser but not the other devices also resulted in
a lower transcutaneous pCO2 and improved respiratory system
compliance in study 2.
CONCLUSIONSThese findings suggest that
among the devices tested, the delivery of salbutamol aerosol to the
lower respiratory tract was greatest using the ultrasonic nebuliser,
and least with the jet nebulisers.
© 1998 by Archives of Disease in Childhood
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