Inhalation Therapy with Bronchosecretolytis Drugs

Abstract

It is estimated that as many as 30% of patients have chronic nonspecific airway disease; most frequently this is chronic bronchitis. For these patients anesthesia during an operation is a high risk, for they often get complications, especially exacerbations of the chronic inflammation of the bronchi or pneumonia. These complications are caused by the interference with the mucociliar clearance produced by the anesthesia for 24 hours after general anesthesia. The impairment of the mucus transport in patients with chronic inflammation of the bronchi is dangerous, particularly when these patients have an increased bronchial secretion. Inhalation of bronchosecretolytic substances is one possible way to prevent these complications. This method was used for many years; patients with cough and expectoration usually get inhalations from the croup kettle before and more often after an operation. However, it is now apparent that these croup kettles are not the way to bring secretolytic aerosols into the bronchial system because the droplets produced by this apparatus are too big to pass beyond the glottis. Aerosols produced by compressed air or supersonic waves reach the smaller airways and permit pharmacological action of the inhaled drugs in the peripheral airways. Although many substances were used for this purpose, it is very difficult to establish which drugs are effective. Also there is considerable uncertainty as to how often and how long inhalations with secretolytic mists should be given.