title: Effect of salmeterol/fluticasone combination on the dynamic changes of lung mechanics in mechanically ventilated COPD patients: a prospective pilot study.
abstract: BACKGROUND
  The combined therapy of inhaled corticosteroids and long-acting beta-2 agonists for mechanically ventilated patients with COPD has never been explored. Therefore, the aim of this study was to investigate their dynamic effects on lung mechanics and gas exchange.
  
  
  METHODS
  Ten mechanically ventilated patients with resolution of the causes of acute exacerbations of COPD were included. Four puffs of salmeterol 25 μg/fluticasone 125 μg combination therapy were administered. Lung mechanics, including maximum resistance of the respiratory system (Rrs), end-inspiratory static compliance, peak inspiratory pressure (PIP), plateau pressure, and mean airway pressure along with gas exchange function were measured and analyzed.
  
  
  RESULTS
  Salmeterol/fluticasone produced a significant improvement in Rrs and PIP after 30 minutes. With regard to changes in baseline values, salmeterol/fluticasone inhalation had a greater effect on PIP than Rrs. However, the therapeutic effects seemed to lose significance after 3 hours of inhaled corticosteroid/long-acting beta-2 agonist administration.
  
  
  CONCLUSIONS
  The combination of salmeterol/fluticasone-inhaled therapy in mechanically ventilated patients with COPD had a significant benefit in reducing Rrs and PIP.
authors: Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Wei-Chih
authors: WC
authors: Chen
authors: Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Hung-Hsing
authors: HH
authors: Chen
authors: Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Chi-Huei
authors: CH
authors: Chiang
authors: Sijhih Cathay General Hospital, Taipei, Taiwan.
authors: Yu-Chin
authors: YC
authors: Lee
authors: Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Kuang-Yao
authors: KY
authors: Yang
mesh_terms: D000280:Administration, Inhalation; D000368:Aged; D000369:Aged, 80 and over; D001993:Bronchodilator Agents / Q000008:administration & dosage; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D000068297:Fluticasone-Salmeterol Drug Combination / Q000008:administration & dosage; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D012121:Respiration, Artificial / Q000379:methods*; D012129:Respiratory Function Tests / Q000379:methods; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D000068297:Fluticasone-Salmeterol Drug Combination
keywords: COPD; inhaled corticosteroid; long-acting beta-2 agonist; mechanical ventilation; respiratory failure