Heliox-Driven Albuterol Therapy in Severe Persistent Asthma with Acute Exacerbation

氦氧混合氧驅動下對重度氣喘急性發作病患使用支氣管擴張劑化霧治療時的影響

李琳(David Lin Lee) ； 姜霟霆(H-T Chiang) ； 張雅雯(Alice Y-W Chang) ； 張學文(Hsueh-Wen Chang) ； 黃裕欽(Yuh-Chin T. Huang)

《胸腔醫學》 19卷3期 (2004/06) Pp. 178-186

https://doi.org/10.29806/TM.200406.0002

摘要

Background: The helium-oxygen mixture (heliox)-powered nebulizer improves the delivery of albuterol to the peripheral lung, but its role in managing acute asthma attacks, however, remains controversial.
Methods: To compare the bronchodilator effect produced by albuterol inhalation delivered by a heliox-powered nebulizer with that by an air-O2-powered nebulizer in severe asthmatics with acute exacerbation, we conducted a prospective, double-blinded randomized controlled trial in a tertiary university-affiliated medical center in Taiwan. Eighty severe persistent asthmatics (FEV1＜60% predicted) with acute exacerbation were randomized to receive 2 doses of albuterol via a nebulizer driven by air-O2 or heliox (80:20). All patients received intravenous methylprednisolone. Arterial blood gas (ABG), hemodynamics, spirometric data, and dyspnea scores were collected before and after albuterol treatments.
Results: Patients receiving heliox-driven albuterol had a higher peak expiratory flow rate (PEFR) (heliox vs. air-O2=44.9±6.1% vs. 38.4±7.8% after the 2(superscript nd) treatment, p＜0.01), and a lower dyspnea score (heliox vs. air-O2=2.4±1.1 vs. 4.0±1.1 after the 2(superscript nd) treatment, p＜0.01).
Conclusion: We conclude that albuterol delivered by a heliox-driven nebulizer may be a useful adjunct therapy in severe persistent asthmatics with acute exacerbation.

關鍵字

氦氣 ； 氣喘 ； 最大吐氣流量 ； 急促指數 ； 第一秒最大吐氣量

並列摘要

Background: The helium-oxygen mixture (heliox)-powered nebulizer improves the delivery of albuterol to the peripheral lung, but its role in managing acute asthma attacks, however, remains controversial.
Methods: To compare the bronchodilator effect produced by albuterol inhalation delivered by a heliox-powered nebulizer with that by an air-O2-powered nebulizer in severe asthmatics with acute exacerbation, we conducted a prospective, double-blinded randomized controlled trial in a tertiary university-affiliated medical center in Taiwan. Eighty severe persistent asthmatics (FEV1＜60% predicted) with acute exacerbation were randomized to receive 2 doses of albuterol via a nebulizer driven by air-O2 or heliox (80:20). All patients received intravenous methylprednisolone. Arterial blood gas (ABG), hemodynamics, spirometric data, and dyspnea scores were collected before and after albuterol treatments.
Results: Patients receiving heliox-driven albuterol had a higher peak expiratory flow rate (PEFR) (heliox vs. air-O2=44.9±6.1% vs. 38.4±7.8% after the 2(superscript nd) treatment, p＜0.01), and a lower dyspnea score (heliox vs. air-O2=2.4±1.1 vs. 4.0±1.1 after the 2(superscript nd) treatment, p＜0.01).
Conclusion: We conclude that albuterol delivered by a heliox-driven nebulizer may be a useful adjunct therapy in severe persistent asthmatics with acute exacerbation.

並列關鍵字

Helium ； bronchial asthma ； peak expiratory flow rate ； dyspnea score ； forced expiratory volume in 1st second