Use of oxygen driven nebulizer delivery systems for beta —2 agonists in chronic bronchitis
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Alterations in arterial blood gas tensions when 100% oxygen or compressed air was used as a driving gas for nebulised salbutamol were studied in ten patients with severe airways obstruction. The patients fell into two groups. Four had chronic bronchitis and emphysema without carbon dioxide retention, the remaining six had chronic bronchitis and emphysema with carbon dioxide retention. When oxygen was used as a driving gas in the latter group, patients showed a mean rise of 1.67 kPa in PaCO2 (p<0.001) after ten minutes. The PaCO2 did not return to baseline for 80 minutes after stopping the nebuliser. The non CO2 retainers showed no rise in CO2 on oxygen. When air was used as a driving gas there was no significant rise in PaCO2 or fall in PaO2 in either group.
While oxygen can be used with impunity as a nebulizer, driving gas in patients suffering from obstructive airways disease without CO2 retention it may be hazardous to do so in those with CO2 retention. In this latter group, compressed air should preferably be used.
KeywordsSalbutamol Chronic Bronchitis Obstructive Airway Disease Nebulised Salbutamol Severe Airway Obstruction
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