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Effect of Heliox- and Air-Driven Nebulized Bronchodilator Therapy on Lung Function in Patients with Asthma

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Abstract

Background

This study compares the effect of heliox-driven to that of air-driven bronchodilator therapy on the pulmonary function test (PFT) in patients with different levels of asthma severity.

Methods

One-hundred thirty-two participants were included in the study. Participants underwent spirometry twice with bronchodilator testing on two consecutive days. Air-driven nebulization was used one day and heliox-driven nebulization the other day in random order crossover design. After a baseline PFT, each participant received 2.5 mg of albuterol sulfate nebulized with the randomized driving gas. Post bronchodilator PFT was repeated after 30 min. The next day, the exact same protocol was repeated, except that the other driving gas was used to nebulize the drug. Participants were subgrouped and analyzed according to their baseline FEV1 on day 1: Group I, FEV1 ≥80 %; Group II, 80 % > FEV1 > 50 %; Group III, FEV1 ≤50 %. The proportion of participants with greater than 12 % and 200-mL increases from their baseline FEV1 and the changes from baseline in PFT variables were compared between heliox-driven versus air-driven bronchodilation therapy.

Results

The proportion of participants with >12 % and 200-mL increases from their baseline FEV1 with air- or heliox-driven bronchodilation was not different with respect to the proportion of participants with baseline FEV1 ≥80 % (20 vs. 18 %, respectively) and 80 % > FEV1 > 50 % (36 vs. 43 %, respectively), but it was significantly greater with heliox-driven bronchodilation in participants with FEV1 ≤50 % (43 vs. 73 %, respectively; p = 0.01). Changes from baseline FVC, FEV1, FEV1/FVC, FEF25–75 %, FEFmax, FEF25 %, FEF50 %, and FEF75 % were significantly larger with heliox-driven versus air-driven bronchodilation in participants with baseline FEV1 ≤50 %.

Conclusion

Improvements in PFT variables are more frequent and profound with heliox-driven compared to air-driven bronchodilator therapy only in asthmatic patients with baseline FEV1 ≤50 %.

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Acknowledgments

The authors acknowledge the help of Ms. Juliette Jibrail and Ms. Lina Itani, Technologist in the Pulmonary Function Laboratory, as well as the staff of the Inhalation Therapy Department at the American University of Beirut Medical Center.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Anesthesiology, American University of Beirut, Beirut, Lebanon

    Mohamad F. El-Khatib & Marwan Alawieh

  2. Department of Medicine, Kings County Hospital Center, Brooklyn, NY, USA

    Ghassan Jamaleddine

  3. Division of Pulmonary and Critical Care, Department of Medicine, American University of Beirut, Beirut, Lebanon

    Nadim Kanj, Salah Zeineddine, Hassan Chami, Imad Bou-Akl, Ahmad Husari & Pierre Bou-Khalil

Authors
  1. Mohamad F. El-Khatib
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  2. Ghassan Jamaleddine
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  3. Nadim Kanj
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  4. Salah Zeineddine
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  5. Hassan Chami
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  6. Imad Bou-Akl
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  7. Ahmad Husari
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  8. Marwan Alawieh
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  9. Pierre Bou-Khalil
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Corresponding author

Correspondence to Pierre Bou-Khalil.

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El-Khatib, M.F., Jamaleddine, G., Kanj, N. et al. Effect of Heliox- and Air-Driven Nebulized Bronchodilator Therapy on Lung Function in Patients with Asthma. Lung 192, 377–383 (2014). https://doi.org/10.1007/s00408-014-9570-0

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  • DOI: https://doi.org/10.1007/s00408-014-9570-0

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