Comparison of the effectiveness of nebulizer treatment applications in acute exacerbation of chronic obstructive pulmonary disease: a randomized controlled trial.

Objective: In addition to oxygen support, bronchodilator therapy constitutes the most essential treatment step in patients with chronic obstructive pulmonary disease. Our study aimed to compare the effectiveness of nebulizer treatments in patients who presented to the emergency department with acute exacerbation of chronic obstructive pulmonary disease.

Methods: Our study included 60 Group E chronic obstructive pulmonary disease patients admitted to the emergency department due to acute exacerbation of chronic obstructive pulmonary disease between June and September 2023 (NCT: 06178068). Patients were randomized as follows: Group 1: jet nebulizer treatment; Group 2: dry air nebulizer treatment; and Group 3: classic nebulizer treatment.

Results: While an increase in forced vital capacity (FVC) and forced expiratory volume 1 (FEV1) levels was observed in Group 1 patients (in the order of p=0.009 and 0.007), a decrease in residual volume (RV) and total lung capacity (TLC) levels was observed (p=0.02 and 0.05, respectively). At the same time, an increase in FEV1 levels was observed in Group 2 and 3 patients (p=0.04 and 0.04, respectively). A decrease was observed in RV and TLC levels (p=0.02, 0.05, 0.02, and 0.04, respectively). When comparing the respiratory function test parameters at the beginning and on the fifth day of treatment, FEV1 and peak expiratory flow 25/75 (PEF25/75) levels were higher in Group 1 patients than in Group 2 and 3 patients (p=0.01 and 0.02, respectively).

Conclusion: In chronic obstructive pulmonary disease patients, jet nebulizer treatment is more effective regarding bronchodilator activity than other nebulizer treatments. However, dry air nebulizer treatment may be preferred in chronic obstructive pulmonary disease patients because it is easily applicable and sterilizable.