Salbutamol delivery during non-invasive mechanical ventilation in patients with chronic obstructive pulmonary disease: a randomized, controlled study

Intensive Care Med. 2001 Oct;27(10):1627-35. doi: 10.1007/s001340101062.


Objective: We investigated the clinical response to equivalent doses of salbutamol delivered, via metered dose inhaler (MDI) during non-invasive mechanical ventilation (NIMV-MDI), during spontaneous breathing using a spacer (MDI-Spacer), and also during intermittent positive pressure breathing (IPPB).

Setting: A respiratory intensive care unit.

Design: Prospective, randomized, and placebo-controlled study.

Patients: Eighteen stable patients with chronic obstructive pulmonary disease (mean FEV1=38.5+/-8.8% predicted).

Results: Overall salbutamol administration induced, compared to placebo, a significant improvement in FEV1, irrespective of the mode of administration (+7.9+/-7.1% or +108+/-91 ml for IPPB, +9.6+/-8.8% or 112+/-67 ml for MDI-NIMV (inspiratory pressure=14.3+/-1.8 cmH2O; expiratory pressure=none), and +10.8+/-11.4% or 119+/-114 ml for MDI-Spacer, respectively). DeltaFVC significantly increased from placebo only in MDI-NIMV (+214+/-182 ml P=0.02). A second set of experiments performed in eight patients to ascertain the possible effect of NIMV on pulmonary function tests, showed a significant improvement from baseline values in FVC both after the delivering of placebo or salbutamol via NIMV-MDI (+206+/-147 ml and 208+/-145, respectively). FEV1 significantly increased only after salbutamol. No changes in gas exchange were observed after bronchodilator delivery.

Conclusions: We show that delivery of bronchodilators via MDI with a spacer chamber during NIMV is feasible and induces a significant bronchodilator effect compared to placebo, even though it may be slightly less effective than the classical delivery system (MDI-Spacer).

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Inhalation
  • Aged
  • Albuterol / administration & dosage*
  • Albuterol / pharmacology
  • Blood Gas Analysis
  • Bronchodilator Agents / administration & dosage*
  • Bronchodilator Agents / pharmacology
  • Critical Care / methods
  • Feasibility Studies
  • Female
  • Forced Expiratory Volume / drug effects
  • Hemodynamics / drug effects
  • Humans
  • Intermittent Positive-Pressure Breathing / instrumentation
  • Intermittent Positive-Pressure Breathing / methods
  • Male
  • Masks*
  • Middle Aged
  • Nebulizers and Vaporizers*
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / metabolism
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Respiration, Artificial / instrumentation*
  • Respiration, Artificial / methods*
  • Tidal Volume
  • Treatment Outcome
  • Vital Capacity / drug effects


  • Bronchodilator Agents
  • Albuterol

Grants and funding