A preliminary study to identify correlations between blood glucose levels and cardiorespiratory observations in acute asthma patients receiving nebulised salbutamol
Introduction: Physiological changes experienced by asthma patients receiving nebulised salbutamol in the acute setting primarily offers therapeutic effects. However, the potential for blood glucose levels to increase in some patients could cause metabolic effects that prolong exacerbations. Could using blood glucose levels as a marker assist in maximising the therapeutic effects of salbutamol, whilst reducing the adverse effects? Method: All pre-coded asthma calls were collated over a year from one UK ambulance service and filtered to identify those where at least two concurrent doses of nebulised salbutamol were administered. Patients that also received hydrocortisone or adrenaline as part of their treatment were removed, along with those that did not have pulse rate, respiratory rate, blood oxygenation (SpO2) and blood glucose levels recorded pre and post nebulisation. Results: Over the timeframe 281 asthma patients who received nebulised salbutamol from ambulance crews also had pre and post nebulisation observations recorded. Eighty patients received concurrent doses without the addition of adrenaline or hydrocortisone. Of these 80 patients; 38 (48%) showed an increase in blood glucose levels, with 17 (21%) also showing an increase in Pulse Rate, 7 (9%) an increase in respiratory rate and 6 (8%) a decrease in SpO2. Conclusion: Although full parameters were not set, the potential for some asthmatics to have an underlying susceptibility to beta-2 agonists such as salbutamol is shown by the number of patients that demonstrated an increased blood glucose level and other undesirable effects following nebulisation.