Objective: In COPD patients with acute respiratory failure (ARF), bronchodilating agents administered by inhalation have in general little effect on dynamic hyperinflation and concurrent static intrinsic positive end-expiratory pressure (PEEPi,st). Since in COPD the severity obstructed segments of the lung may not be reached by inhaled medication, we reasoned that drug efficiency may be enhanced by intravenous administration of the agent. Design: Physiological study Setting: Two four-bed surgical-medical ICUs of a University hospital Patients: Fourteen COPD patients were studied within 36 hours from the onset of ARF. Measurements and results: Static compliance (Cst,rs), minimal (Rmin,rs) and additional (ΔRrs) resistance of the respiratory system, and PEEPi,st were measured before and after intravenous administration of salbutamol. All patients were flow limited before and after salbutamol administration. On average, after salbutamol there was a small though significant decrease in Rmin,rs (-9%), ΔRrs (-12%) and PEEPi,st (-8%). Conclusion: The changes in resistance and PEEPi,st after intravenous administration of salbutamol were too small to be of clinical significance.
Responsiveness to intravenous administration of salbutamol in chronic obstructive pulmonary disease patients with acute respiratory failure.
VOLTA, Carlo Alberto;ALVISI, Raffaele;RAGAZZI, Riccardo;
2001
Abstract
Objective: In COPD patients with acute respiratory failure (ARF), bronchodilating agents administered by inhalation have in general little effect on dynamic hyperinflation and concurrent static intrinsic positive end-expiratory pressure (PEEPi,st). Since in COPD the severity obstructed segments of the lung may not be reached by inhaled medication, we reasoned that drug efficiency may be enhanced by intravenous administration of the agent. Design: Physiological study Setting: Two four-bed surgical-medical ICUs of a University hospital Patients: Fourteen COPD patients were studied within 36 hours from the onset of ARF. Measurements and results: Static compliance (Cst,rs), minimal (Rmin,rs) and additional (ΔRrs) resistance of the respiratory system, and PEEPi,st were measured before and after intravenous administration of salbutamol. All patients were flow limited before and after salbutamol administration. On average, after salbutamol there was a small though significant decrease in Rmin,rs (-9%), ΔRrs (-12%) and PEEPi,st (-8%). Conclusion: The changes in resistance and PEEPi,st after intravenous administration of salbutamol were too small to be of clinical significance.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
