title: Effect of regular use of high-dose nebulized beta2-agonists on resting energy expenditure, weight, and handgrip strength in patients with chronic airflow limitation.
abstract: OBJECTIVE
  A proportion of patients with chronic airflow limitation (CAL) have a raised resting energy expenditure (REE). The mechanism underlying this is not known. The question of whether the increased REE seen in some patients with CAL is due to beta2-agonist therapy has arisen, and the aim of this study was to examine REE, body composition, and peripheral muscle strength in patients before and after the use of regular high-dose beta2-agonists administered by nebulizer.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Respiratory outpatient clinic.
  
  
  METHODS
  Twenty outpatients with CAL being considered for a home nebulizer prescription.
  
  
  METHODS
  REE was measured by indirect calorimetry. Fat-free mass and handgrip strength were measured. Quality of life was assessed by the St. George's Hospital Respiratory Questionnaire. All subjects were assessed independently of this study for provision of a home nebulizer using a standard protocol. Based on the assessment, either standard-dose salbutamol therapy was continued or a nebulizer was provided with a prescription for high-dose salbutamol (5 mg qd). A mean of 8.1 months later (range, 3 to 16 months), 16 patients were restudied.
  
  
  RESULTS
  Eight patients had been taking regular high-dose nebulized salbutamol, and eight had continued taking standard-dose salbutamol by metered dose inhaler. There was no difference in baseline measures between the group who were later prescribed high-dose salbutamol and the group who were not. There were no changes in REE, anthropometric measures, or handgrip strength over time in either of the groups.
  
  
  CONCLUSIONS
  The long-term use of high-dose nebulized beta2-agonists in patients with chronic airflow limitation has no effect on baseline REE, handgrip strength, weight, or body composition.
authors.affiliation: Chelsea and Westminster Hospital, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Congleton
authors.forename: M F
authors.initials: MF
authors.lastname: Muers
mesh_terms: D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage*; D001835:Body Weight; D004734:Energy Metabolism; D005260:Female; D018737:Hand Strength; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D011446:Prospective Studies; D011788:Quality of Life
chemical_list: D000318:Adrenergic beta-Agonists; D000420:Albuterol