Administration of aerosolized terbutaline and budesonide reduces chlorine gas-induced acute lung injury.
BACKGROUND
The pathophysiology and treatment of chlorine gas-induced acute lung injury is poorly characterized and based on anecdotal data. This study aimed to assess the effects of aerosolized beta-2 adrenergic agonist and corticosteroid therapy on chlorine gas-induced lung injury.


METHODS
Anesthetized, ventilated pigs were exposed to chlorine gas (400 parts per million for 20 minutes), then assigned randomly 30 minutes later to receive aerosolized terbutaline, budesonide, terbutaline followed by budesonide or placebo (6 pigs in each group). Hemodynamics, gas exchange, and lung mechanics were evaluated for another 5 hours.


RESULTS
All the animals demonstrated an immediate increase in airway and pulmonary artery pressure as well as sharp drops in arterial oxygen tension (PaO2) and lung compliance (CL). Recovery of PaO2 and CL was greatest in the terbutaline plus budesonide group, but therapy with terbutaline and budesonide alone also was associated with significant improvement in PaO2 and CL, as compared with placebo.


CONCLUSIONS
Treatment of acute chlorine gas lung injury with aerosolized terbutaline followed by aerosolized budesonide improved lung function. Combined treatment was more effective than treatment with either drug alone.
Wang
Jianpu
J
Section of Disaster Medicine, Department of Biomedicine and Surgery, Faculty of Health Sciences, University of Linköping, Linköping, Sweden. jiawa@ibk.liu.se
Zhang
Liming
L
Walther
Sten M
SM
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000336:Aerosols; D000818:Animals; D001784:Blood Gas Analysis; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019819:Budesonide / Q000008:administration & dosage / Q000627:therapeutic use*; D002713:Chlorine / Q000633:toxicity*; D004334:Drug Administration Schedule; D005260:Female; D006339:Heart Rate; D010101:Oxygen Consumption; D012128:Respiratory Distress Syndrome / Q000139:chemically induced / Q000188:drug therapy*; D013552:Swine; D013726:Terbutaline / Q000008:administration & dosage / Q000627:therapeutic use*
D000318:Adrenergic beta-Agonists; D000336:Aerosols; D001993:Bronchodilator Agents; D002713:Chlorine; D019819:Budesonide; D013726:Terbutaline