Responsiveness to intravenous administration of salbutamol in chronic obstructive pulmonary disease patients with acute respiratory failure

A. Volta, Carlo; Alvisi, Raffaele; Marangoni, Elisabetta; R. Righini, Ermino; Verri, Marco; Ragazzi, Riccardo; Alvisi, Valentina; Ferri, Enrico; Milic-Emili, Joseph
December 2001
Intensive Care Medicine;Dec2001, Vol. 27 Issue 12, p1949
Academic Journal
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. Design: Physiological study. Setting: Two four-bed surgical-medical ICUs of a university hospital. Patients: Fourteen COPD patients were studied within 36 h from the onset of ARF. Measurements and results: Static compliance (Cst,rs), minimal (Rmin,rs) and additional (ΔRrs) 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%), ΔRrs (-12%) and PEEPi,st (-8%). Conclusion: The changes in resistance and PEEPi,st after intravenous administration of salbutamol were too small to be of clinical significance.


Related Articles

  • Authors' response. Chakrabarti, Biswajit; Angus, Robert M.; Calverley, Peter M. A. // Thorax;May2011, Vol. 66 Issue 5, p450 

    The article presents the author's reply to a response by M. P. Wise, A. P. Brooks, and M. H. Purcell-Jones to his work in chronic obstructive pulmonary disease patients with decompensated hypercapnic respiratory failure which appeared in an issue published in 2009.

  • Positive End-Expiratory Pressure Setting in Adults With Acute Lung Injury and Acute Respiratory Distress Syndrome. Mercat, Alain; Richard, Jean-Christopher M.; Vielle, Bruno; Jaber, Samir; Osman, David; Diehl, Jean-Luc; Lefrant, Jean-Yves; Prat, Giemaël; Richecoeur, Jack; Nieszkowska, Ania; Gervais, Claude; Baudot, Jérôme; Bouadma, Lila; Brochard, Laurent // JAMA: Journal of the American Medical Association;2/13/2008, Vol. 299 Issue 6, p646 

    The article discusses research which compared the effect on outcome of a strategy for setting positive end-expiratory pressure (PEEP) aimed at increasing alveolar recruitment while limiting hyperinflation to one aimed at minimizing alvolear distension in patients with acute lung injury (ALI)....

  • Protection from experimental ventilator-induced acute lung injury by IL-1 receptor blockade. Frank, J. A.; Pittet, J.-F.; Wray, C.; Matthay, M. A. // Thorax;Feb2008, Vol. 63 Issue 2, p147 

    Background: Clinical studies have shown that injurious mechanical ventilation is associated with increased airspace and plasma levels of interleukin-1beta (IL-1beta); however, the potential therapeutic value of IL-1 inhibition in acute lung injury has not been thoroughly...

  • Noninvasive ventilation in hypercapnic acute respiratory failure due to chronic obstructive pulmonary disease vs. other conditions: effectiveness and predictors of failure. Phua, Jason; Kong, Kien; Lee, Kang Hoe; Shen, Liang; Lim, T.; Lim, T K // Intensive Care Medicine;Apr2005, Vol. 31 Issue 4, p533 

    Objective: This study compared the effectiveness of noninvasive ventilation (NIV) and the risk factors for NIV failure in hypercapnic acute respiratory failure (ARF) due to chronic obstructive pulmonary disease (COPD) vs. non-COPD conditions.Design and Setting:...

  • Always Consider the Possibility of Opioid Induced Respiratory Depression in Patients Presenting with Hypercapnic Respiratory Failure Who Fail to Improve as Expected with Appropriate Therapy. Steynor, Martin; MacDuff, Andrew // Case Reports in Critical Care;3/29/2015, Vol. 2015, p1 

    Hypercapnic respiratory failure is a frequently encountered medical emergency. Two common causes are acute exacerbations of chronic obstructive pulmonary disease (COPD) and as a side effect of opioids. The two causes may coexist leading to diagnostic confusion and consequent delay in optimal...

  • Rhabdomyolysis in Acute Severe Asthma: A Case Report and Literature Review. Upadhyay, Daya; Dave, Sandeep; Corbridge, Thomas // Internet Journal of Asthma, Allergy & Immunology;2002, Vol. 2 Issue 2, p39 

    An elevated serum CPK and the presence of myoglobin in the urine characterize rhabdomyolysis. Rhabdomyolysis has been described in various traumatic and non-traumatic conditions; there are few reports of its association with acute severe asthma. In this paper, we report a case of acute severe...

  • Use of NPPV in Chronic Respiratory Failure. Cooney, Joseph // American Family Physician;2/1/2000, Vol. 61 Issue 3, p841 

    Discusses research on the use of noninvasive positive pressure ventilation (NPPV) in chronic respiratory failure. Reference to a study by J. T. Rabatin and P. C. Gay, from the August 1999 issue of the `Mayo Clinic Proceedings'; How NPPV is being applied to the patient; Effectiveness of NPPV in...

  • It's Time to Reappraise the Impact of Auto-PEEP. Shih-Chi Ku // Respiratory Care;Feb2016, Vol. 61 Issue 2, p258 

    The article discusses a study by G. Natalini et al to address and assess the factors contributing to the development of auto-PEEP in subjects receiving mechanical ventilation without an active ventilator trigger. It cites several implications of the study such as clarifying and measuring...

  • Aminophylline for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Rice, Kathryn L.; Leatherman, James W.; Duane, Peter G.; Snyder, Linda S.; Harmon, Keith R.; Abel, Jeffrey; Niewoehner, Dennis E. // Annals of Internal Medicine;Sep87, Vol. 107 Issue 3, p305 

    Assesses the effect of the introduction of a third immunosuppressive agent azathioprine, on the rate of decline in airflow variables in eight heart-lung transplant recipients with obliterative bronchitis. Comparison of this rate with that in five patients who did not receive augmented...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics