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Change in Oxygen Consumption Following Inhalation of Albuterol in Comparison with Levalbuterol in Healthy Adult Volunteers

  • Asthma
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Abstract

Background

Albuterol is the most commonly used β agonist to treat reversible lower airway obstruction. Albuterol contains a racemic mixture of two enantiomers. Levalbuterol contains the single R form enantiomer. Levalbuterol is frequently prescribed to limit cardiovascular toxicity.

Objective

We examined changes in oxygen consumption (V’O2) and heart rate (HR) following administration of albuterol and levalbuterol.

Methods

This is a prospective, randomized, single-blinded, controlled study of healthy adult volunteers. Subjects separately received albuterol (5 mg) and levalbuterol (2.5 mg) aerosolized over 15 min. V’O2 and vital signs were measured before the medications and 5, 10, 20, 40, and 60 min after.

Results

We enrolled 24 volunteers with a median age of 32 years. Compared to baseline, there was a significant maximum increase in V’O2 following administration of both albuterol (median 17% (1, 3 IQR 9, 43%) p < 0.001) and levalbuterol (median 23% (1, 3 IQR 10, 32%) p < 0.001). There was no significant difference between the maximum increase in V’O2 following administration of albuterol compared to levalbuterol (p = 0.57). Compared to baseline, there was a significant maximal increase in HR with both albuterol (median 30% (1, 3 IQR 19, 43%) p < 0.001) and levalbuterol (median 23% (1, 3 IQR 19, 31%) p < 0.001). There was a statistically significant greater increase in maximal HR following administration of albuterol as compared to levalbuterol (p = 0.009).

Conclusion

Albuterol and levalbuterol both cause a significant increase in V’O2 and HR. There was no significant difference between albuterol and levalbuterol regarding the maximum increase in V’O2. There was a statistically significant but likely clinically insignificant difference in maximum increase in HR in patients with adequate oxygen delivery when comparing albuterol to levalbuterol.

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Abbreviations

HR:

Heart rate

V’O2 :

Oxygen consumption

RR:

Respiratory rate

V E :

Minute ventilation

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Funding

No external funding was secured for this study.

Author Contributions

All of the authors are responsible for the research. We have all participated in the concept and design, analysis and interpretation of data, and drafting and revision of the manuscript. We have all approved the manuscript as submitted.

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Authors and Affiliations

  1. Department of Pediatrics, Section of Critical Care, Texas Children’s Hospital, Baylor College of Medicine, 6621 Fannin Street, Houston, TX, 77030, USA

    Manpreet K. Virk

  2. Department of Anesthesiology and Critical Care, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Justin Hotz, Robinder G. Khemani, Christopher J. L. Newth & Patrick A. Ross

Authors
  1. Manpreet K. Virk
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  2. Justin Hotz
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  3. Robinder G. Khemani
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  4. Christopher J. L. Newth
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  5. Patrick A. Ross
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Corresponding author

Correspondence to Manpreet K. Virk.

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Conflict of interest

The authors have no conflicts of interest or financial relationships relevant to this article to disclose.

Ethical Approval

The study was approved by the Institutional Review Board at Children’s Hospital Los Angeles.

Informed Consent

Informed consent was obtained from all the participating subjects.

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Virk, M.K., Hotz, J., Khemani, R.G. et al. Change in Oxygen Consumption Following Inhalation of Albuterol in Comparison with Levalbuterol in Healthy Adult Volunteers. Lung 195, 233–239 (2017). https://doi.org/10.1007/s00408-017-9982-8

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  • DOI: https://doi.org/10.1007/s00408-017-9982-8

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