The effects of nebulised isotonic saline and terbutaline on breathlessness in severe chronic obstructive pulmonary disease (COPD).
BACKGROUND
There is anecdotal evidence that nebulised saline relieves breathlessness at rest in patients with severe chronic obstructive pulmonary disease (COPD). It is unclear whether nebulised beta agonists are any more effective than nebulised saline in relieving breathlessness at rest in these individuals.


OBJECTIVE
To compare the effects of nebulised saline and nebulised terbutaline on breathlessness at rest in patients with severe COPD.


METHODS
We studied 18 patients with severe COPD with a mean age of 71.1 years, forced expiratory volume in 1 second (FEV1) of 0.58 L and vital capacity (VC) of 1.59 L, in a randomised, double-blind, crossover trial. The subjects received three doses of nebulised saline on one study day, and three doses of nebulised terbutaline (cumulative dose 10 mg) on the other. Breathlessness was measured using Likert and Visual Analogue Scales (VAS).


RESULTS
Both treatments led to a significant improvement in breathlessness on VAS and Likert scales but there was no significant difference in breathlessness scores for saline compared with terbutaline. There was a small but significant increase in FEV1 with terbutaline of 74 mL, but no change with saline.


CONCLUSIONS
A saline aerosol has no effect on lung function but reduces breathlessness at rest in subjects with severe COPD. Nebulised saline may be considered as an adjunct to the use of nebulised bronchodilators for the treatment of breathlessness in patients with COPD.
Department of Medicine, Faculty of Medicine and Health Sciences, University of Auckland, NZ.
P J
PJ
Poole
S M
SM
Brodie
J M
JM
Stewart
P N
PN
Black
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage*; D000336:Aerosols; D000368:Aged; D000369:Aged, 80 and over; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004417:Dyspnea / Q000188:drug therapy*; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D010147:Pain Measurement; D012965:Sodium Chloride / Q000008:administration & dosage*; D013726:Terbutaline / Q000008:administration & dosage*; D016896:Treatment Outcome; D014797:Vital Capacity / Q000187:drug effects
D000318:Adrenergic beta-Agonists; D000336:Aerosols; D012965:Sodium Chloride; D013726:Terbutaline