COPD Nebulizers: Oxygen-driven vs Air-driven

According to a study in BMC Pulmonary Medicine, air-driven nebulizers are preferred to oxygen-driven nebulizers for COPD patients.

Researchers compared the effects of air versus oxygen-driven bronchodilator nebulization on arterial carbon dioxide tension in exacerbations of COPD.

Ninety patients hospitalized with AECOPD were randomized to receive two 2.5 mg salbutamol nebulizers, both driven by air or oxygen at 8 L/min, each delivered over 15 min with a 5 min interval in-between.

According to results, average PtCO₂ change at 35 min was 3.4 mmHg in the oxygen-driven nebulizer group and 0.1 mmHg in the air-driven nebulizer group. Additionally, 18 of 45 patients in the oxygen-driven group had a PtCO₂change ?4 mmHg during the intervention, compared to 0 of 44 patients in the air-driven group (40% vs 0%).

Researchers concluded that oxygen-driven nebulization leads to an increase in PtCO₂ in exacerbations of COPD. “We propose that air-driven bronchodilator nebulisation is preferable to oxygen-driven nebulisation in exacerbations of COPD,” they wrote.