Effectiveness Of Nebulised Budesonide On Breathing Mechanics In Pneumoconiosis Undergoing Massive Whole Lung Lavage

Objectives For patients with pneumoconiosis,abnormal indicators of respiratory mechanics such as bronchospasm due to increased airway reactivity can be observed during massive whole lung lavage.Aerosol inhalation of budesonide is effective in the prevention of bronchial asthma and treatment of chronic airway inflammation.In this study,modified oxygen-driven aerosol inhalation device was used during WLL to inhale budesonide suspension?Pulmicort respulas?.Its influence on indicators of respiratory mechanics of lung on lavage side was observed to explore the practicality and scientificity of WLL combined with aerosol inhalation of budesonide suspension.Methods 180 patients with pneumoconiosis,who were admitted to China's Coal Miners Beidaihe Sanatorium from 2013 to 2014 and underwent large-volume whole lung lavage treatment,were selected as research subjects?stage one,60 cases;stage two,60 cases;stage three,60 cases?and then were divided,according to random number table,into an experiment group and a control group.Patients in the experiment group were treated with aerosol inhalation of budesonide and normal saline during operation while the patients in the control group with aerosol inhalation of normal saline only.The data of the research subjects were collected,including: peak inspiratory pressure before and immediately after atomization and at 15 min,30 min,45 min,and 60 min after atomization,expiratory resistance,lung compliance,work of breathing.Results 1.There were significant differences between the two groups in Airway peak pressure,respiratory resistance,respiratory energy and lung compliance?P<0.01?The Peak Airway pressure,respiratory resistance,respiratory energy and lung compliance in the two groups were significantly different?P<0.05?.2.Changes of peak inspiratory pressures were compared between the two groups of patients: peak inspiratory pressures at 15 min,30 min,45 min,and 60 min after the atomization in the experiment group were?38.12±6.82?cmH₂O,?35.94±6.30?cmH₂O,?34.25±5.97?cmH₂O,and?33.97±5.80?cmH₂O,respectively and an obvious trend of their gradual decrease was observed.Comparison between the two groups at different time points showed statistically significant difference?P<0.05?;comparison of peak inspiratory pressures of patients of the two groups at 15 min,30 min,45 min,60 min after atomization and their peak inspiratory pressures before atomization showed statistically significant difference.3.Changes in expiratory resistance were compared between the two groups of patients: the expiratory resistances of patients in the experiment group at 15 min,30 min,45 min and 60 min after atomization were?34.12±6.74?cmH₂O/L/S,?32.18±7.56?cmH₂O/L/S,?30.56±8.75?cmH₂O/L/S and?29.14±7.81?cmH₂O/L/S,respectively and an obvious trend of gradual decrease was observed.Comparison of expiratory resistance between the two group at 30 min,45 min,60 min after atomization showed statistically significant difference;comparison of expiratory resistance of patient in the two groups at 15 min,30 min,45 min,and 60 min after atomization and their expiratory resistance before atomization showed statistically significant difference?P<0.05?.4.Changes of work of breathing were compared between the two groups: The work of breathing of patients in the experiment group at 15 min,30 min,45 min,and 60 min after atomization were?2.61±0.57?J,?2.52±0.43?J,?2.40±0.42?J,?2.36±0.52?J,respectively and a obvious trend of gradual decrease was observed.Comparison between the two groups at 15 min,30 min,45 min,60 min after atomization showed statistically significant difference;comparison of work of breathing of patients in the two groups at 15 min,30 min,45 min,60 min after atomization and their work of breathing before atomization showed statistically significant difference?P<0.05?.5.Changes of lung compliance were compared between the two groups of patients: lung compliance of patients in experiment group at 15 min,30 min,45 min,and 60 min after atomization were?26.85±6.39?ml/cmH₂O,?28.38±7.12?ml/cmH₂O,?29.87±7.37?ml /cmH₂O and?31.86±7.58?ml/cmH₂O,respectively and an obvious trend of gradual decrease was observed.Comparison between the two groups at 15 min,30 min,45 min,60 min after atomization showed statistically significant difference;comparison of lung compliance of patients in the two groups at 15 min,30 min,45 min,60 min after atomization and their lung compliance before atomization showed statistically significant difference?P<0.05?.Conclusions Aerosol inhalation of budesonide for patients undergoing large-volume whole lung lavage can reduce their peak inspiratory pressure,work of breathing,respiratory resistance and promote the recovery of their lung compliance,thus improving the safety of WLL.Figure 6;Table 6;Reference 65...