Responsiveness to intravenous administration of salbutamol in chronic obstructive pulmonary disease patients with acute respiratory failure.
OBJECTIVE
In chronic obstructive pulmonary disease (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 severely 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.


METHODS
Physiological study.


METHODS
Two four-bed surgical-medical ICUs of a university hospital.


METHODS
Fourteen COPD patients were studied within 36 h from the onset of ARF.


RESULTS
Static compliance (Cst,rs), minimal (Rmin,rs) and additional (DeltaRrs) resistance of the respiratory system, and PEEPi,st were measured before and after intravenous administration of salbutamol. All patients had limitation of air flow before and after salbutamol administration. On average, after salbutamol there was a small, though significant, decrease in Rmin,rs (-9%), DeltaRrs (-12%) and PEEPi,st (-8%).


CONCLUSIONS
The changes in resistance and PEEPi,st after intravenous administration of salbutamol were too small to be of clinical significance.
Volta
C A
CA
Department of Surgical, S. Anna Hospital, University of Ferrara, Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy. vlc@dns.unife.it
Alvisi
R
R
Marangoni
E
E
Righini
E R
ER
Verri
M
M
Ragazzi
R
R
Alvisi
V
V
Ferri
E
E
Milic-Emili
J
J
D000208:Acute Disease; D000368:Aged; D000403:Airway Resistance / Q000187:drug effects; D000420:Albuterol / Q000627:therapeutic use*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D016018:Least-Squares Analysis; D008297:Male; D018467:Positive-Pressure Respiration, Intrinsic; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012131:Respiratory Insufficiency / Q000188:drug therapy*; D015656:Respiratory Mechanics / Q000187:drug effects; D018709:Statistics, Nonparametric
D001993:Bronchodilator Agents; D000420:Albuterol