title: A modified nebulization modality versus classical ultrasonic nebulization and oxygen-driven nebulization in facilitating airway clearance in patients with acute exacerbation of chronic obstructive pulmonary disease: a randomized controlled trial.
abstract: BACKGROUND
  Ultrasonic nebulization (UN) and oxygen-driven nebulization (ON), two commonly used modalities for nebulization inhalation, are not ideally suitable for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
  
  
  METHODS
  A total of 91 patients with AECOPD were randomized to three groups given different nebulization modalities: ON, UN, and ultrasonic nebulization with warming and oxygen (UNWO). The sputum clearance, lung function, changes in physiological measures such as peripheral oxygen saturation (SpO2) and tolerance to these nebulization modalities were recorded and compared among the three groups.
  
  
  RESULTS
  The time to the first expectoration was shorter and the sputum volume was larger after UN and UNWO than after ON (both P<0.01). Compared with pre-nebulization, SpO2 significantly increased (P<0.01) and the dyspnea decreased significantly (P<0.05) after UNWO. The SpO2 and dyspnea post-UNWO were significantly better than those post-UN (P<0.01, P<0.05), but not statistically different from those post-ON (both P>0.05). UNWO demonstrated significantly greater comfort and longer duration of nebulization than UN (P<0.01, P<0.05), but no significant differences in these respects from ON (both P>0.05). Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF) decreased significantly after UNWO (P<0.05, P<0.01, and P<0.01, respectively).
  
  
  CONCLUSIONS
  UNWO may promote expectoration of sputum with fewer adverse reactions and a higher level of comfort than simple UN and ON. Therefore, it can be used as an adjuvant therapy for AECOPD patients.
authors.affiliation: 1 College of Health Sciences, Guangzhou Medical University, Guangzhou 510120, China ; 2 State Key Laboratory of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Qiaoling
authors.initials: Q
authors.lastname: Luo
authors.affiliation: 1 College of Health Sciences, Guangzhou Medical University, Guangzhou 510120, China ; 2 State Key Laboratory of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Zeguang
authors.initials: Z
authors.lastname: Zheng
authors.affiliation: 1 College of Health Sciences, Guangzhou Medical University, Guangzhou 510120, China ; 2 State Key Laboratory of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Huihong
authors.initials: H
authors.lastname: Cen
authors.affiliation: 1 College of Health Sciences, Guangzhou Medical University, Guangzhou 510120, China ; 2 State Key Laboratory of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Jiang
authors.affiliation: 1 College of Health Sciences, Guangzhou Medical University, Guangzhou 510120, China ; 2 State Key Laboratory of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Chen
keywords: Oxygen-driven nebulization (ON); acute exacerbation of chronic obstructive pulmonary disease (AECOPD); chronic obstructive pulmonary disease (COPD); sputum expectoration; ultrasonic nebulization (UN); ultrasonic nebulization with warming and oxygen (UNWO)