Nebulized Hypertonic Saline for Inpatient Use in COPD

Hypothesis:

A clinically significant difference exists between albuterol treatments with nebulized 3%
saline versus standard saline, for improvements in the patient's modified Borg dyspnea score
during an acute exacerbation of COPD.Study

Population:

This study will involve 146 patients admitted to Doctors Hospital in Columbus, Ohio from
September 2014 through September 2015 with a clinical diagnosis of an acute exacerbation of
COPD, defined as an increase in the patient's dyspnea, cough, or change in sputum
consistency/volume/color from the patient's baseline during stable conditions.

Study Design:

Patients will be randomly assigned to 2.5 mg albuterol treatments with either normal saline,
as is the standard, or hypertonic saline.

Once the patient is enrolled, they will be randomly assigned to 2.5 mg albuterol treatments
with either normal saline, as is the standard, or hypertonic saline. They will then receive
the 2.5mg albuterol treatment, and saline solution as determined by the randomization plan
(Group 1 will receive 0.9% saline and Group 2 will receive 3% saline), every six hours for at
least the first 24 hours, with allowance for PRN (pro re nata= as needed) use every four
hours by patient request.

The patient's dyspnea will be evaluated prior to starting the treatment and after the
intervention period is completed using the Modified Borg Dyspnea Scale.

Inclusion Criteria:

- Patients at least 18 years of age

- Admitted to Doctors Hospital with a clinical diagnosis of COPD

- Documented obstruction on spirometry from prior records available at the time of the
study.

Exclusion Criteria:

- Patients younger than 18 years of age

- Spirometry data not available

- History of smoking less than twenty pack-years

- Possibility of other primary cause of the patient's change in dyspnea or cough (e.g.
pneumonia, congestive heart failure with pulmonary edema, myocardial infarction)

- Patient is found to have a different primary cause after initial enrollment

- Non-English speaking subjects