RANDOMIZED CROSSOVER TRIAL OF SALBUTAMOL AEROSOL DELIVERED BY METERED-DOSE INHALER, JET NEBULIZER, ACID ULTRASONIC NEBULIZER IN CHRONIC LUNG-DISEASE

Aims-To compare the efficacy of salbutamol delivered by metered dose i nhaler (MDI), jet nebuliser, and ultrasonic nebuliser in ventilated in fants with chronic lung disease. Methods-Twenty preterm ventilated inf ants with chronic lung disease were enrolled in two studies. In study 1 (n=10), each infant was given 200 mu g of salbutamol at 4 hour inter vals 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 pO(2), pCO(2), and oxygen saturation, respiratory system resistance and compl iance before and after each treatment. Infants in study 2 (n=10) were similarly studied except for the use of a different jet nebuliser. Res ults-The 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 pO(2) were associated with the use of the ultra sonic nebuliser or MDI than with the jet nebulisers in both studies. T he use of the ultrasonic nebuliser but not the other devices also resu lted in a lower transcutaneous pCO(2) and improved respiratory system compliance in study 2. Conclusions-These findings suggest that among t he devices tested, the delivery of salbutamol aerosol to the lower res piratory tract was greatest using the ultrasonic nebuliser, and least with the jet nebulisers.