Effects of Inhaled Albuterol and Ipratropium Bromide on Autonomic Control of the Cardiovascular System

Dagnone, A. Joel; Parlow, Joel L.

doi:10.1378/chest.111.6.1514

Cited by 16 publications

(7 citation statements)

References 33 publications

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“…Our study did not demonstrate statistically significant changes in pulse rate after salbutamol in any group, showing an absence of chronotropic effect of 400 μg salbutamol. This is consistent with the study by Dagnone et al . We cannot discount the possible cardiovascular effects on the alteration in alveolar ventilation and perfusion relationship in our study design.…”

Section: Discussionsupporting

confidence: 93%

“…11,25,26 Our study did not demonstrate statistically significant changes in pulse rate after salbutamol in any group, showing an absence of chronotropic effect of 400 mg salbutamol. This is consistent with the study by Dagnone et al 27 We cannot discount the possible cardiovascular effects on the alteration in alveolar ventilation and perfusion relationship in our study design. However, these effects may not be large as salbutamol did not affect DL,CO in the normal spirometry group, suggesting that none of the cardiovascular effects was potent enough to cause measurable changes in DL,CO.…”

Section: Discussionsupporting

confidence: 93%

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Effect of salbutamol on the measurement of single‐breath diffusing capacity

et al. 2013

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 93%

Effect of salbutamol on the measurement of single‐breath diffusing capacity

et al. 2013

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“…Indices of autonomic circulatory control have been shown by our group and numerous other investigators to be quite stable over time and between study days at baseline conditions in a variety of study populations. 19,[23][24][25] For this reason a time control group was not justified, and the changes in measurements over time can be assumed to be due primarily to drug effects at the different infusion rates. In addition, although the investigators administering the protocol were unblinded and could have been biased in the assignment of sedation scores, the drug infusion scheme was designed to target specific plasma concentrations, rather than titrating to sedation score.…”

Section: Methodsmentioning

confidence: 99%

Autonomic circulatory and cerebrocortical responses during increasing depth of propofol sedation/hypnosis in humans

Lafreniere

Milne

Brunet

et al. 2000

Can J Anesth/J Can Anesth

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Purpose: To describe the relative effects of graded central nervous system (CNS) depression, using increasing propofol infusion rates, on neurovegetative brainstem-mediated circulatory control mechanisms and higher cortical activity in healthy humans.Methods: Propofol was administered using an infusion scheme designed to achieve three target blood concentrations in ten healthy volunteers. Blood propofol concentrations and sedation scores were determined at baseline, during the three propofol infusion levels, and 30 min into the recovery period. Electroencephalographic (EEG) power was measured in three frequency bands to quantify cortical activity, and autonomic heart rate control was quantified using spontaneous baroreflex assessment and power spectral analysis of pulse interval. Results: Sedation scores closely paralleled propofol blood concentrations (0, 0.53 ± 0.34, 1.24 ± 0.21, 3.11 ± 0.80, and 0.96 ± 0.42 µg·mL -1 at baseline, three infusion levels and recovery respectively), and all subjects were unconscious at the deepest level. Indices of autonomic heart rate control were decreased only at the deepest levels of CNS depression, while EEG effects were apparent at all propofol infusion rates. These EEG effects were frequency specific, with power in the beta band being affected at light levels of sedation, and alpha and delta power altered at deeper levels. Conclusions: The results of this study support a relative preservation of neurovegetative circulatory control mechanisms during the early stages of CNS depression using gradually increasing rates of infusion of propofol. Indices of circulatory control did not reliably reflect depth of sedation.Objectif : Décrire les effets relatifs d'une dépression graduée du système nerveux central (SNC) sur les mécanismes d'origine centrale du contrôle neurovégétatif de la circulation, et l'activité corticale supérieure chez des humains sains, en utilisant des perfusions de propofol à vitesses croissantes. Méthode : Le propofol a été administré, chez dix volontaires en santé, selon un schéma de perfusion conçu pour atteindre trois concentrations sanguines cibles. Les concentrations sanguines de propofol et les scores de sédation ont été déterminés au départ, pendant les trois régimes de perfusion de propofol et à 30 min pendant la récupéra-tion. La puissance électroencéphalographique (EEG) a été mesurée selon trois bandes fréquentielles pour quantifier l'activité corticale, et le contrôle autonome de la fréquence cardiaque a été mesuré à l'aide d'une évaluation baroréflexe spontanée et de l'analyse spectrale de la puissance de l'intervalle pulsé.Résultats : Les scores de sédation ont présenté un étroit parallélisme avec les concentrations sanguines de propofol (0; 0,53 ± 0,34, 1,24 ± 0,21; 3,11 ± 0,80, et 0,96 ± 0,42 µg·mL -1 au début, pendant les trois perfusions et la récupération, respectivement), et tous les sujets ont connu un profond sommeil. Les indices de contrôle autonome de la fréquence cardiaque ont diminué seulement au moment de la plus profonde dépression d...

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“…Patients with autonomic dysfunction (acute myocardial infarction, severe brain or spinal cord impairment) or heavy levels of sedation with no response to stimuli were also excluded from the study. Inhaled albuterol and ipratropium bromide were permitted, as they have shown no effect on autonomic control of HR (Dagnone & Parlow, 1997). Approval for this study was obtained by the Queen's University Health Sciences Human Research Ethics Board.…”

Section: Participantsmentioning

confidence: 99%

Effects of Endotracheal Tube Suctioning on Arterial Oxygen Tension and Heart Rate Variability

Bourgault¹,

Brown

Hains³

et al. 2006

Biological Research For Nursing

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The purpose of this study was to examine the autonomic mechanisms underlying changes in heart rate (HR) and systolic blood pressure (SBP) responses to endotracheal tube (ETT) suctioning and to compare the open versus closed methods of ETT suctioning on these measures and on arterial oxygen tension. Eighteen orally intubated participants, 33 to 82 years of age (M = 60 years), were randomized for the order of suctioning method. Arterial oxygen tension (PaO2) was measured before suctioning and 30 s and 5 min following suctioning. Beat-to-beat HR and arterial blood pressure data were collected for 10-min periods before and after suctioning. HR and SBP measures were analyzed before suctioning and 1 min and 5 min following suctioning. Although there were no significant effects of ETT suctioning on the autonomic mechanisms of HR modulation and no significant differences between the two methods of suctioning, ETT suctioning resulted in an increase in HR, SBP, and PaO2. However, there was a decrease in the parasympathetic nervous system indicator of HR variability (HRV) following open suctioning. All patients in this study maintained a PaO2 level 80 mm Hg, which may account for our lack of significant autonomic changes. This suggests that hyperoxygenation with 100% oxygen for a minimum of 1 min (or 20 breaths), as delivered by preoxygenation modes available on most microprocessor ventilators, should be the method of choice for all hyperoxygenation procedures to avoid a decrease in PaO2 following suctioning.

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Effects of Inhaled Albuterol and Ipratropium Bromide on Autonomic Control of the Cardiovascular System

Cited by 16 publications

References 33 publications

Effect of salbutamol on the measurement of single‐breath diffusing capacity

Effect of salbutamol on the measurement of single‐breath diffusing capacity

Autonomic circulatory and cerebrocortical responses during increasing depth of propofol sedation/hypnosis in humans

Effects of Endotracheal Tube Suctioning on Arterial Oxygen Tension and Heart Rate Variability

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