Nuesslein T G, Wallis H, Stephan V, Rieger C
Universitäts-Kinderklinik Bochum.
Pneumologie. 2003 Aug;57(8):433-8. doi: 10.1055/s-2003-41544.
Inhaled salbutamol is well known to be effective in obstructive lung disease in the paediatric age group. However, the individually necessary dose cannot be predicted in a single patient. Two inhalation techniques were compared measuring the concentrations of salbutamol in the bronchial lavage fluid.
Forty nine children, age 2 to 73 months, inhaled salbutamol immediately before bronchoscopy, either 200 microg using a metered dose inhaler (MDI) or 2000 microg using a nebulizer (NEB). The concentrations of salbutamol were measured in the bronchial lavage fluid.
In spite of different inhaled doses the concentrations of salbutamol were similar in the nebulizer group (n = 29) and the metered dose inhaler group (n = 20) (medians 160 vs. 163 ng/ml; p = 0.27) with a wide range in both groups (12 to 1139 and 5.2 to 641 ng/ml, respectively). In a single patient the concentrations differed by the factor 159 between the right and the left lung. The concentrations of salbutamol were not age dependent (p = 0.06 for NEB, p = 0.28 for MDI).
In infants and young children the concentrations of salbutamol in the bronchial lavage fluid vary widely after a single inhalation using either a metered dose inhaler or a nebulizer.
吸入沙丁胺醇在儿科年龄段的阻塞性肺病中疗效显著,这是众所周知的。然而,无法预测单个患者所需的剂量。通过测量支气管灌洗 fluid 中沙丁胺醇的浓度,对两种吸入技术进行了比较。
49名年龄在2至73个月的儿童在支气管镜检查前立即吸入沙丁胺醇,其中20名使用定量吸入器(MDI)吸入200微克,29名使用雾化器(NEB)吸入2000微克。测量支气管灌洗 fluid 中沙丁胺醇的浓度。
尽管吸入剂量不同,但雾化器组(n = 29)和定量吸入器组(n = 20)中沙丁胺醇的浓度相似(中位数分别为160和163纳克/毫升;p = 0.27),两组的浓度范围都很广(分别为12至1139和5.2至641纳克/毫升)。在一名患者中,左右肺之间的浓度相差159倍。沙丁胺醇的浓度与年龄无关(雾化器组p = 0.06,定量吸入器组p = 0.28)。
在婴幼儿中,使用定量吸入器或雾化器单次吸入后,支气管灌洗 fluid 中沙丁胺醇的浓度差异很大。