Document Detail


Airway hyperresponsiveness to ultrasonically nebulized distilled water in subjects with tetraplegia.
MedLine Citation:
PMID:  10194198     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The majority of otherwise healthy subjects with chronic cervical spinal cord injury (SCI) demonstrate airway hyperresponsiveness to aerosolized methacholine or histamine. The present study was performed to determine whether ultrasonically nebulized distilled water (UNDW) induces airway hyperresponsiveness and to further elucidate potential mechanisms in this population. Fifteen subjects with SCI, nine with tetraplegia (C4-7) and six with paraplegia (T9-L1), were initially exposed to UNDW for 30 s; spirometry was performed immediately and again 2 min after exposure. The challenge continued by progressively increasing exposure time until the forced expiratory volume in 1 s decreased 20% or more from baseline (PD20) or the maximal exposure time was reached. Five subjects responding to UNDW returned for a second challenge 30 min after inhalation of aerosolized ipratropium bromide (2.5 ml of a 0.6% solution). Eight of nine subjects with tetraplegia had significant bronchoconstrictor responses to UNDW (geometric mean PD20 = 7.76 +/- 7.67 ml), whereas none with paraplegia demonstrated a response (geometric mean PD20 = 24 ml). Five of the subjects with tetraplegia who initially responded to distilled water (geometric mean PD20 = 5.99 +/- 4.47 ml) were not responsive after pretreatment with ipratropium bromide (geometric mean PD20 = 24 ml). Findings that subjects with tetraplegia are hyperreactive to UNDW, a physicochemical agent, combined with previous observations of hyperreactivity to methacholine and histamine, suggest that overall airway hyperresponsiveness in these individuals is a nonspecific phenomenon similar to that observed in patients with asthma. The ability of ipratropium bromide to completely block UNDW-induced bronchoconstriction suggests that, in part, airway hyperresponsiveness in subjects with tetraplegia represents unopposed parasympathetic activity.
Authors:
D R Grimm; E Arias; M Lesser; W A Bauman; P L Almenoff
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of applied physiology (Bethesda, Md. : 1985)     Volume:  86     ISSN:  8750-7587     ISO Abbreviation:  J. Appl. Physiol.     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-05-03     Completed Date:  1999-05-03     Revised Date:  2013-09-26    
Medline Journal Info:
Nlm Unique ID:  8502536     Medline TA:  J Appl Physiol (1985)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1165-9     Citation Subset:  IM    
Affiliation:
Spinal Cord Damage Research Center, Veterans Affairs Medical Center, Bronx 10468, New York, New York 10029, USA. drgrimm@prodigy.net
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MeSH Terms
Descriptor/Qualifier:
Adult
Aerosols
Bronchoconstriction / drug effects,  physiology
Bronchodilator Agents / administration & dosage,  pharmacology
Humans
Ipratropium / administration & dosage,  pharmacology
Male
Nebulizers and Vaporizers
Paraplegia / etiology,  physiopathology*
Quadriplegia / etiology,  physiopathology*
Respiratory Mechanics / physiology*
Smoking
Spinal Cord Injuries / physiopathology*
Spirometry
Ultrasonics
Water / administration & dosage,  pharmacology*
Chemical
Reg. No./Substance:
0/Aerosols; 0/Bronchodilator Agents; 60205-81-4/Ipratropium; 7732-18-5/Water

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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