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Ultrasonic nebulization of water and mucoevacuant solutions in patients with obstructive lung disease: volumetric and ventilatory responses to acute administration.

The effects of two inhalations each of 100 ml of a mucoevacuant and water generated ultrasonically during separate eight-hour trials after bronchodilator aerosol priming, were assessed by the behaviour of 12 plethysmographic and spirometric indices and by the volume and dry weight of sputum produced for 15 patients with obstructive ventilatory disorders and retained secretions. The mucoevacuant was statisticallysuperior to water in improving FEF200-1,200, Ra and Ra × Vtg values and in narrowing the FVC2-FVC1 index of air trapping; there was suggestive evidence of the greater worth of the former in reducing control elevations in the RV/TLC ratio. Sputum volume and dry weight were both greater after mucoevacuant mist inhalation. No unwelcome clinical effects accompanied the mucoevacuant mist exposure, whereas the cough and wheezing breathlessness of two patients worsened during ultrasonic nebulization of water solutions. Symptomatic betterment accompanied the improvement in physiologic measurements of most patients during mucoevacuant trials, with the majority of the same patients showing little clinical change during the water inhalation sessions.The data suggest that the helpful changes in respiratory indices recorded may be related to mucoevacuant-induced mobilization of retained secretions and improvement in faulty bronchial catharsis.