Am. J. Respir. Crit. Care Med., Vol 154, No. 1, Jul 1996, 156-160.
The effects of albuterol on the lung function of hospitalized patients with cystic fibrosis
NL Hordvik, PH Sammut, CG Judy, SJ Strizek and JL Colombo
Department of Pediatric Pulmonology, University of Nebraska Medical Center, Omaha 68198-5190, USA.
Twenty-four hospitalized patients with cystic fibrosis were enrolled into a
2-d, double-blind, placebo-controlled, randomized crossover trial comparing
albuterol inhalation aerosol with a saline placebo. Aerosols were
administered with the first three of four chest physiotherapy sessions
given 4 h apart. Spirometry was measured before and 45 min after 7:00 A.M.
and 3:00 P.M. therapy and before therapy at 7:00 P.M. and 7:00 A.M. the
next morning. The mean percent change in FVC, FEV1, and FEF25-75% at 7:00
A.M. was 10.7, 14.8, and 19.6% with albuterol versus 2.4, 1.0, and -0.8%
with placebo (p = 0.0012, < 0.0001, and = 0.003, respectively). A
greater than 8% change in FEV1 separated changes with albuterol versus
placebo with 96% specificity and occurred in 75% of all patients with
albuterol; 71% at 7:00 A.M. versus 24% at 3:00 P.M. The reduction in
response at 3:00 P.M. (p < 0.01) was presumably due to prolonged effects
of morning therapy ( > 4 h). Individual changes in spirometry were
significantly more positive and homogeneous with albuterol versus placebo
at both 7:00 A.M. and 3:00 P.M. The mean percent change for the FVC, FEV1,
and FEF25-75 across the day (7:00 A.M. pretherapy to 7:00 P.M. pretherapy)
was 8.1, 10.1, and 9.7% with albuterol versus 3.9, 3.5 and 2.6% with
placebo (p = 0.029, 0.036, and 0.232, respectively). The more positive and
homogeneous changes in spirometry with albuterol, along with greater
changes in these measures across the day when compared with placebo,
suggest that albuterol improves pulmonary function in a majority of
hospitalized patients with cystic fibrosis.
