Document Detail


Bronchodilators in patients with chronic obstructive pulmonary disease on mechanical ventilation. Utilization of metered-dose inhalers.
MedLine Citation:
PMID:  2136979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Bronchodilators are used widely in the acute exacerbations of chronic obstructive pulmonary disease (COPD), although their effectiveness is not clearly established. We used three bronchodilators in 20 patients with COPD who were being mechanically ventilated. Two of the bronchodilators, ipratropium bromide and salbutamol, were administered from metered-dose inhalers (MDI) through an adapter to the endotracheal tube, and the third, aminophylline, was administered in the form of intravenous infusion. Before administering each drug, peak airway pressure, end-inspiratory pressure, resistive pressure, and auto positive end-expiratory pressure (auto-PEEP) were measured, and inspiratory resistance (Rins) and compliance were calculated. Heart rate (HR) and blood pressure were also recorded, and arterial pH and blood gas determinations were made. These measurements were repeated 60 min after the administration of aminophylline, 15 and 60 min after administering salbutamol, and 30 and 60 min after administering ipratropium bromide. With these three drugs, airway pressures were reduced, as well as auto-PEEP and Rins, with respect to basal values (p less than 0.05). The changes in compliance were only significant with salbutamol (p less than 0.05). HR was only significantly modified with aminophylline (p less than 0.05). No blood gas change was observed with any of the three drugs. It can be concluded that: (1) the three drugs used in this study were equally effective in producing significant bronchodilation in patients on mechanical ventilation for severe acute exacerbation of COPD; (2) the administration of bronchodilators by MDI in intubated patients through a special adapter was as effective as the intravenous administration of aminophylline.
Authors:
A Fernandez; A Lazaro; A Garcia; C Aragon; E Cerda
Related Documents :
10921579 - Biologically variable ventilation increases arterial oxygenation over that seen with po...
20673339 - Control of positive end-expiratory pressure (peep) for small animal ventilators.
6370599 - Neonatal pneumopericardium: analysis of ventilatory variables.
9655729 - The pressure-volume curve is greatly modified by recruitment. a mathematical model of a...
19649399 - Variable positive end-expiratory pressure can maintain oxygenation in experimental acut...
10527249 - Adapting prognostic respiratory variables of ards in children to small-scale community ...
8143709 - Basic mechanisms and clinical consequences of cyclic changes in pulmonary blood flow an...
904019 - High pressure injection injury of the hand.
1415969 - Thoracic electrical bioimpedance measurement of cardiac output and cardiovascular respo...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American review of respiratory disease     Volume:  141     ISSN:  0003-0805     ISO Abbreviation:  Am. Rev. Respir. Dis.     Publication Date:  1990 Jan 
Date Detail:
Created Date:  1990-02-22     Completed Date:  1990-02-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370523     Medline TA:  Am Rev Respir Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  164-8     Citation Subset:  AIM; IM    
Affiliation:
Servicio de Cuidados Intensivos, Hospital Central de la Cruz Roja, Madrid, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Albuterol / administration & dosage,  therapeutic use
Aminophylline / administration & dosage,  therapeutic use
Bronchodilator Agents / administration & dosage*,  therapeutic use
Female
Hemodynamics / drug effects
Humans
Ipratropium / administration & dosage,  therapeutic use
Lung Diseases, Obstructive / drug therapy,  physiopathology,  therapy*
Male
Middle Aged
Nebulizers and Vaporizers*
Respiration, Artificial*
Respiratory Mechanics / drug effects
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 18559-94-9/Albuterol; 317-34-0/Aminophylline; 60205-81-4/Ipratropium

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


Previous Document:  Left lower lobe ventilation is reduced in patients with cardiomegaly in the supine but not the prone...
Next Document:  Left ventricular hypertrophy in men with normal blood pressure: relation to exaggerated blood pressu...