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THE EFFECT OF SALBUTAMOL ON RESTING ENERGY EXPENDITURE (REE) IN PATIENTS WITH CYSTIC FIBROSIS

The effect of salbutamol on REE was studied in 8 patients with CF and 5 healthy controls. REE was measured by open circuit indirect calorimetry after an overnight fast (12-14 hr) in 3 consecutive phases: no intervention, 2 ml-0.9% NaCl inhalation, and 2 ml 0.9% NaCl + 5 mg salbutamol inhalation (60m/20m/60 min respectively). Salbutamol levels were measured simultaneously every 15 min and determined by reversed phase liquid chromatography. There was no statistically significant difference in the response of CF and control subjects, and results were therefore pooled (n=13).There was an increase in salbutamol blood levels, and a concomitant rise in heart rate and REE in response to salbutamol inhalation. REE increased by 10% during the first hour following salbutamol inhalation. We conclude that since inhaled salbutamol may be used several times a day it may have a significant effect, increasing total daily energy expenditure of patients with chronic lung disease. This observation should be considered in the overall management of patients with chronic lung disease such as CF, asthma and chronic bronchitis.