PURPOSE: To evaluate the efficacy and safety of 400 μg inhaled Salbutamol as bronchodilator for reversibility testing in spirometric evaluation (from new ATS/ERS recommendation for standardization of spirometry 2005).
METHODS: Prospective randomized controlled trial with 200 and 400 μg inhaled Salbutamol in patients received spirometric evaluation at pulmonary division between October 2006- March 2007. Routine pre and postbronchodilator spirometric parameters and pulse rate (by pulse oximetry) were recorded at 5,10,15,30 and 60 minute respectively. Palpitation and tremor were also noted. Electrocardiography will be performed when pulse rate is above 100/min.
RESULTS: There were 232 patients enrolled, with 113 and 119 of them received 200 and 400μg inhaled Salbutamol during spirometric evaluation respectively. Base-line diagnoses, demographic and spirometric parameters were not different between the two groups.Post bronchodilator, patients in both groups showed no statistical significant differences of the following parameters: 1) FVC, FEV1, FEF25-75 (%predicted) and FEV1/FVC ratio (84±16 vs 85±17, p=0.764; 77±22 vs 74±19, p=0.425; 56.2±30 vs 50.7±29, p=0.14; and 72.4±13.4 vs 70.3±14.6, p=0.249 respectively). 2) Pulse rates at all measured intervals. 3) Side effects of palpitation and tremor. However, a small but non-significant number of cardiac arrhythmia was observed in 4 patients (1 in 200μg and 3 in the 400μg groups respectively).
CONCLUSION: 200 and 400μg inhaled Salbutamol exhibited equivalent bronchodilating effects in routine spirometric evaluations with minimal side effect.
CLINICAL IMPLICATIONS: Since 200 and 400μg inhaled Salbutamol are equally effective, higher dose (400μg) inhaled Salbutamol should be used cautiously in patients who are vulnerable to cardiac arrhythmia.
DISCLOSURE: Theerasuk Kawamatawong, No Financial Disclosure Information; No Product/Research Disclosure Information