Grainge C, Brown R, Jugg B J, Smith A J, Mann T M, Jenner J, Rice P, Parkhouse D A
Institute of Naval Medicine, Alverstoke, Hampshire.
J R Army Med Corps. 2009 Jun;155(2):105-9. doi: 10.1136/jramc-155-02-05.
To examine the effectiveness of nebulised salbutamol in the treatment of phosgene induced acute lung injury.
Using previously validated methods, 12 anaesthetised large white pigs were exposed to phosgene (Ct 1978 +/- 8 mg min m(-3)), established on mechanical ventilation and randomised to treatment with either nebulised salbutamol (2.5 mg per dose) or saline control. Treatments were given 1, 5, 9, 13, 17 and 21 hours following phosgene exposure. The animals were followed to 24 hours following phosgene exposure.
Salbutamol treatment had no effect on mortality and had a deleterious effect on arterial oxygenation, shunt fraction and heart rate. There was a reduction in the number of neutrophils from 24.0% +/- 4.4 to 12.17% +/- 2.1 (p < 0.05) in bronchoalveolar lavage, with some small decreases in inflammatory mediators in bronchoalveolar lavage but not in plasma.
Nebulised salbutamol treatment following phosgene induced acute lung injury does not improve survival, and worsens various physiological parameters including arterial oxygen partial pressure and shunt fraction. Salbutamol treatment reduces neutrophil influx into the lung. Its sole use following phosgene exposure is not recommended.
研究雾化吸入沙丁胺醇治疗光气所致急性肺损伤的有效性。
采用先前验证的方法，将12只麻醉的大白猪暴露于光气（Ct为1978±8毫克·分钟·立方米⁻³），建立机械通气后随机分为雾化吸入沙丁胺醇（每剂2.5毫克）治疗组或生理盐水对照组。在光气暴露后1、5、9、13、17和21小时给予治疗。对动物随访至光气暴露后24小时。
沙丁胺醇治疗对死亡率无影响，对动脉氧合、分流分数和心率有不良影响。支气管肺泡灌洗中中性粒细胞数量从24.0%±4.4降至12.17%±2.1（p<0.05），支气管肺泡灌洗中的一些炎症介质略有减少，但血浆中未减少。
光气所致急性肺损伤后雾化吸入沙丁胺醇治疗不能提高生存率，且会使包括动脉血氧分压和分流分数在内的各种生理参数恶化。沙丁胺醇治疗可减少中性粒细胞流入肺内。不建议在光气暴露后单独使用。
