Nebulizer vs Spacer for Bronchodilator Delivery in Patients Hospitalized for Acute Exacerbations of COPD: MonitoringMonitoring
On admission, spirometry, an arterial blood gas analysis, a chest roentgenogram, and determination of the theophylline level were done. Spirometric data (Vitalograph) and a Borg dyspnea score were obtained before each treatment block and 1 h after nebulizer inhalation was begun (referred to as 1 h after treatment). The best values for FEV, and FVC of at least three attempts were selected and recorded in BTPS units. The Borg score is an interval scale that contains the numbers 0 to 10 associated with the statements, “0=nothing at all; 1 = very, very light;. . . 9=very heavy; 10=very, very heavy.” Subjects were asked to indicate their degree of dyspnea after they were presented with a poster containing the scale. Systolic and diastolic blood pressure and heart rate were measured before each treatment block, at five minutes after MDI-spacer and nebulizer treatments, and 1 h after the start of nebulizer administration. avandia online

Analysis
The FEV„ FVC, and Borg scores were subjected to an analysis of variance for repeated measures using order (active drug via MDI-spacer in treatment block 1 or 2) as a between-subjects factor and treatment (before vs 1 h after) and treatment type (MDI-spacer vs nebulizer) as within-subjects (repeated measures) factors using the BMDP2V program on a computer (MicroVAX; Digital Equipment Corp.). The main effects and interactions between factors were analyzed. A similar analysis was applied to systolic and diastolic blood pressure and heart rate with time (before, five minutes after active drug administration, or 1 h after treatment) and treatment type as repeated-measure factors.
The changes in the FEV„ FVC, and Borg score, as well as the percent change in the FEV, and FVC ([(after-before) x 100]/before) were computed. The changes were also subjected to an analysis of variance for repeated measures with order (active drug via spacer in treatment blocks 1 or 2) as a between-subjects factor and treatment type (MDI-spacer vs nebulizer) as a within-subjects factor. A level of p<0.05 was considered statistically significant. Results are presented as the mean ± SD unless otherwise stated.