| Arterial Oxygen Desaturation after Salbutamol Nebulization in Wheezy Infants and Children |
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Eun Sun Yoo, Jung Won Seo, Seung Joo Lee |
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Department of Pediatrics, Ewha Womans University, College of Medicine, Seoul, Korea |
| 천명성 영유아에서 Salbutamol분무투여에 의한 저산소증의 발생에 대한 연구 |
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유은선, 서정완, 이승주 |
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이화여자대학교 의과대학 소아과학교실 |
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| Abstract |
Purpose
: Nebulized selective β2-adrenoreceptor agonists have been widely used in acute asthma
and selectively in acute bronchiolitis. However, nebulized salbutamol have been reported to cause
arterial oxygen desaturation in some of the acute bronchiolitis and severe asthma patients. This
may be the results of a paradoxical bronchoconstriction linked to acidic and hyper-osmolar
nebulized salbutamol solution and etc. We assessed the changes in arterial oxygen saturation by
percutaneous pulse oxymeter during and after nebulization of salbutamol solution and compared
the effect of 100% oxygen with the compressed air as a driving gas.
Methods
: This study was performed in 80 mild to moderate wheezy children(bronchiolitis 51,
asthma 29) who were admitted to Pediatrics department of of EWHA from January 1992 to
October 1993. The study children are randomly assigned to be nebulized by compressed air or
6l/min of 100% oxygen as a driving gas. The arterial oxygen saturation, wheeze score, retraction
score, and heart rate were recorded before nebulization, post-nebulization, 5, 10, 15 and
30minutes.
Results
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1) Arterial oxygen saturation decreased significantly at post-nebulization five minutes only in
bronchiolitis, treated with salbutamol nebulization without oxygen(p<0.01). Salbutamol
nebulization, with oxygen (6l/min) has not changed arterial oxygen saturation both in bronchiolitis
and asthma(p>0.05).
2) Wheeze score decreased significantly at post-nebulization 5-30minutes in asthma but not in
bronchiolitis whether nebulized salbutamol with or without oxygen(p<0.05).
3) Retraction score increased significantly at post-nebulization 0-5minutes or unchanged in
bronchiolitis but significantly decreased in asthma at 10-30minutes(p<0.05).
4) There were no significant change in heart rate and respiratory rate in both groups(p>0.05).
Conclusion
: Significant fall in arterial oxygen saturation was noted only in bronchiolitis
treated with salbutamol nebulization without oxygen. In bronchiolitis, oxygen (6l/min) is better
than compressed air as a driving gas during salbutamol nebulization to prevent hypoxemia. |
| Key Words:
Nebulized salbutamol solution, Arterial oxygen desaturation, Bronchiolitis and asthma |
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