Effect of albuterol nebulization on peripheral WBC counts

The white blood cell (WBC) count and neutrophil count are commonly used in clinical decision making. It has been established that parenterally administered beta-adrenergic agents will increase the values of both of these measurements as a result of demargination. The purpose of this study was to evaluate whether the same phenomenon occurs when the beta-adrenergic agent albuterol is administered by inhalation. This 3-month study was performed in a prospective, nonblinded manner with each patient serving as their own control, in an urban medical center emergency department (ED). All patients 18 to 55 years of age with an established diagnosis of chronic obstructive pulmonary disease or asthma who were experiencing an exacerbation of their disease that did not appear life threatening were entered onto the study. Patients were excluded if they were immunocompromised, on steroids, or had been seen in the last 2 weeks in the ED. A total of 28 patients were entered in a consecutive volunteer pattern. On presentation to the ED, patients had a baseline complete blood cell (CBC) count with differential obtained. They then were given a small volume nebulization treatment with 0.5 mL of albuterol (2.5 mg) in 3 mL of normal saline during a 15-minute period. A repeat CBC with differential was performed 30 minutes after completion of the treatment. Three patients did not get neutrophil counts recorded. All results are noted as the mean +/- one standard deviation. The WBC count (in 1,000) before (mean, 10.33 +/- 3.48) and after (mean, 10.66 +/- 4.02) albuterol were compared using the two-tailed paired t test.(ABSTRACT TRUNCATED AT 250 WORDS)