Abstract.
Objective: We investigated the clinical response to equivalent doses of salbutamol delivered, via metered dose inhaler (MDI) during non-invasive mechanical ventilation (NIMV-MDI), during spontaneous breathing using a spacer (MDI-Spacer), and also during intermittent positive pressure breathing (IPPB). Setting: A respiratory intensive care unit. Design: Prospective, randomized, and placebo-controlled study. Patients: Eighteen stable patients with chronic obstructive pulmonary disease (mean FEV1=38.5±8.8% predicted). Results: Overall salbutamol administration induced, compared to placebo, a significant improvement in FEV1, irrespective of the mode of administration (+7.9±7.1% or +108±91 ml for IPPB, +9.6±8.8% or 112±67 ml for MDI-NIMV (inspiratory pressure=14.3±1.8 cmH2O; expiratory pressure=none), and +10.8±11.4% or 119±114 ml for MDI-Spacer, respectively). ΔFVC significantly increased from placebo only in MDI-NIMV (+214±182 ml P=0.02). A second set of experiments performed in eight patients to ascertain the possible effect of NIMV on pulmonary function tests, showed a significant improvement from baseline values in FVC both after the delivering of placebo or salbutamol via NIMV-MDI (+206±147 ml and 208±145, respectively). FEV1 significantly increased only after salbutamol. No changes in gas exchange were observed after bronchodilator delivery. Conclusions: We show that delivery of bronchodilators via MDI with a spacer chamber during NIMV is feasible and induces a significant bronchodilator effect compared to placebo, even though it may be slightly less effective than the classical delivery system (MDI-Spacer).
Article PDF
Similar content being viewed by others
Author information
Authors and Affiliations
Additional information
Final revision received: 16 July 2001
Electronic Publication
Rights and permissions
About this article
Cite this article
Nava, S., Karakurt, S., Rampulla, C. et al. Salbutamol delivery during non-invasive mechanical ventilation in patients with chronic obstructive pulmonary disease: a randomized, controlled study. Intensive Care Med 27, 1627–1635 (2001). https://doi.org/10.1007/s001340101062
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s001340101062