Nebulized beta(2)-receptor agonists may cause neutrophil demargination and
result in misleading total circulating leukocyte counts (WBCs) in patients
with acute bronchospasm. Varying underlying adrenergic stimulation in these
patients also makes interpretation of these data difficult. This study exa
mined the direct effect of these agents on the measured WBCs of healthy adu
lts without evidence of bronchospasm or illness.
A prospective, blinded, randomized study of 30 healthy volunteers (aged 18-
50 years) was performed in a controlled environment. Subjects were excluded
if they were pregnant, had a known underlying medical disorder or have had
a prior reaction to albuterol or similar medications. Participants in the
study were given either a nebulized albuterol treatment or nebulized normal
saline (control group). Leukocyte counts were then obtained before and aft
er treatments. Paired data were analysed using a one-tailed t-test while co
nsidering an increase of 40% in WBCs to be significant, P = 0.05, and beta
= 0.10.
Mean leukocyte counts were 5.9 (+/- 1.2) before treatment as compared to 6.
0(+/- 1.3) after albuterol nebulization. Using the coefficient of variance
of`WBCs in normal humans as c. 50% (6000 +/- 3000 cells mm(-1)) we were una
ble to demonstrate a significant difference in variation in post-nebulized
leukocyte counts between the control group and the nebulized albuterol grou
p.
While there is concern that the treatment of patients experiencing acute br
onchospasm with beta(2) agonists may result in factitious elevations in per
ipheral leukocyte counts, we found no direct effect of these agents on meas
ured counts in normal subjects.