Document Detail


The effect of bronchodilators and oxygen alone and in combination on self-paced exercise performance in stable COPD.
MedLine Citation:
PMID:  17000096     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Both oxygen therapy and bronchodilators reduce exertional breathlessness and improve exercise tolerance in patients with stable chronic obstructive pulmonary disease (COPD). However their relative effectiveness and the value of their combined use on exercise performance has not been assessed. The effects of 5 mg of salbutamol plus 500 microg ipratropium bromide nebulisation followed by a 6-min walking test while breathing O(2) were studied in a randomised, single-blind, placebo controlled, crossover trial in 28 patients with severe or very severe COPD, breathless on exertion and with oxygen saturation < or = 89% at rest or on exercise. Bronchodilator reversibility was minimal. The 6-min walking distance increased from 356 (128)m to 377 (117)m after the bronchodilator (P<0.05), to 406 (109)m after supplementary oxygen but without bronchodilators (P 0.011 versus bronchodilators/air and 0.001 versus placebo/air), and to 430 (109)m after the combination of oxygen and the bronchodilators (P<0.0001 versus placebo/air and bronchodilators/air; P=0.014 versus placebo/oxygen). End-exercise dyspnea only fell significantly when oxygen and bronchodilator were combined. In severe or very severe COPD patients with relatively fixed airway obstruction bronchodilators enhance exercise performance obtained with oxygen. Clinically relevant improvement is possible when therapies with a different mechanism of action are combined.
Authors:
Alberto Cukier; Claudia A S Ferreira; Rafael Stelmach; Marcos Ribeiro; Felipe Cortopassi; Peter M A Calverley
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2006-09-26
Journal Detail:
Title:  Respiratory medicine     Volume:  101     ISSN:  0954-6111     ISO Abbreviation:  Respir Med     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-05     Completed Date:  2007-06-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  746-53     Citation Subset:  IM    
Affiliation:
Pulmonary Division, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. pnealberto@incor.usp.br
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MeSH Terms
Descriptor/Qualifier:
Aged
Albuterol / administration & dosage*
Bronchodilator Agents / administration & dosage*
Combined Modality Therapy / methods
Cross-Over Studies
Dyspnea / complications,  physiopathology
Exercise Therapy / methods*
Female
Humans
Ipratropium / administration & dosage*
Male
Nebulizers and Vaporizers
Oxygen / physiology
Oxygen Inhalation Therapy / methods*
Pulmonary Disease, Chronic Obstructive / drug therapy,  physiopathology,  therapy*
Respiration Disorders / complications,  physiopathology
Respiratory Function Tests
Single-Blind Method
Treatment Outcome
Walking
Chemical
Reg. No./Substance:
0/Bronchodilator Agents; 18559-94-9/Albuterol; 60205-81-4/Ipratropium; 7782-44-7/Oxygen

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


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