THE EFFECTS OF NEBULIZED ISOTONIC SALINE AND TERBUTALINE ON BREATHLESSNESS IN SEVERE CHRONIC OBSTRUCTIVE PULMONARY-DISEASE (COPD)

Background: There is anecdotal evidence that nebulised saline relieves breathlessness at rest in patients with severe chronic obstructive pu lmonary disease (COPD). It is unclear whether nebulised beta agonists are any more effective than nebulised saline in relieving breathlessne ss at rest in these individuals.Aim: To compare the effects of nebulis ed saline and nebulised terbutaline on breathlessness at rest in patie nts with severe COPD. Methods: We studied 18 patients with severe COPD with a mean age of 71.1 years, forced expiratory volume in 1 second ( FEV,) of 0.58 L and vital capacity (VC) of 1.59 L, in a randomised, do uble-blind, crossover trial. The subjects received three doses of nebu lised saline on one study day, and three doses of nebulised terbutalin e (cumulative dose 10 mg) on the other. Breathlessness was measured us ing Likert and Visual Analogue Scales (VAS). Results: Both treatments led to a significant improvement in breathlessness on VAS and Likert s cales but there was no significant difference in breathlessness scores for saline compared with terbutaline. There was a small but significa nt increase in FEV, with terbutaline of 74 mL, but no change with sali ne. Conclusion: A saline aerosol has no effect on lung function but re duces breathlessness at rest in subjects with severe COPD. Nebulised s aline may be considered as an adjunct to the use of nebulised bronchod ilators for the treatment of breathlessness in patients with COPD.