Effect of Regular Use of High-dose Nebulized β2-Agonists on Resting Energy Expenditure, Weight, and Handgrip Strength in Patients With Chronic Airflow Limitation: Results

There were no significant differences in prestudy medication between the two study groups: six of eight patients who later received regular nebulizer treatment and six of eight who continued using MDIs were taking inhaled corticosteroids; four of eight vs zero of eight were taking oral corticosteroids; four of eight vs four of eight were taking oral theophylline preparations; one of eight vs zero of eight was taking an oral P2-agonist; and two of eight vs two of eight were taking inhaled ipratropium bromide.
Changes in medication at the time of the second REE study several months later (excluding study medication) were as follows: nebulizer group—two patients were taking nebulized corticosteroids instead of corticosteroids by MDI; two patients were taking a reduced dose of oral prednisolone; and five patients were taking ipratropium, all via the nebulizer; MDI group—one was no longer taking an oral theophylline preparation, and five were now taking ipratropium bromide via an MDI. Direct patient questioning at the time of REE measures confirmed that all patients were taking MDI salbutamol four times daily at the time of the first study, and that all the patients subsequently prescribed nebulized salbutamol were taking this regularly, four times daily at the time of the second measurement, and had been doing so since the time their nebulizer assessment had finished. The mean interval time to the second study was 8.1 months (range, 3 to 16 months) at which time eight patients were using regular nebulized salbutamol, 5 mg four times daily. canadian neighbor pharmacy

As shown in Table 1, there were no differences in terms of baseline age, sex ratio, spirometry, weight, anthropometric measures, symptom score, or REE between the group who were later using nebulized drugs and those who were not. The mean REE of all the patients at the first measurement was 99% predicted and two patients were “hypermetabolic” (REE >110% predicted), one in the nebulizer treatment group and one in the group who continued using MDIs.
Table 1—Baseline Comparisons Between Patients Prescribed Regular Nebulized Salbutamol and Who Continued to Use Inhaled Salbutamol

Age, yr Weight, kg Height, m FEVj, L FVC, L ND HGS, kg % FFM SGRQ
Symptom Activity Impact
Neb (n=8)
Mean 66 59.6 1.6 1.05 2.01 23 71 84 84 56
SD 5.6 15.4 0.13 1.01 1.35 8 8 (71-93)range (48-100) (30-80)
MDI (n=8)
Mean 63 72.7 1.7 1.02 2.11 27 69 83 70 42
SD 11.1 18.1 0.08 0.51 0.63 11 4 (65-98) (54-93) (19-70)
95% Cl (-4.0 to 11.6) (-27.9 to 1.8) (-0.19 to 0.002) (-0.68 to 0.73) (-1.03 to 0.83) (-13 to 4) (-3.8 to 7.0) (-7.3 to 11.4) (-2.4 to 25) (-5.2 to 30.9)
unpaired t test NS NS NS NS NS NS NS NS NS NS
Mann Whitney U