The effects of salbutamol aerosol on lung function in patients with pulmonary emphysema

Bellamy, D.; Hutchinson, D.C.S.

doi:10.1016/0007-0971(81)90052-8

Cited by 39 publications

(23 citation statements)

References 7 publications

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“…Ramsdel e Tisi (41) (14) avaliaram 20 pacientes com evidência radiológica de enfisema pulmonar. Após Bd houve pequeno, mas significativo, aumento no VEF 1 , ocorrendo elevação muito maior na CV, que se acompanhou de redução do VR.…”

Section: ) Bds E Volumes Pulmonaresunclassified

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Resposta a broncodilatador na espirometria: que parâmetros e valores são clinicamente relevantes em doenças obstrutivas?

Rodrigues

Pereira

2001

J. Pneumologia

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Respostas estatísticas dos parâmetros funcionais são largamente utilizadas após administração de broncodilatador (Bd) nos laboratórios de função pulmonar em doenças com obstrução ao fluxo aéreo. Sua relevância clínica é discutível. Objetivo: Determinar que parâmetros espirométricos refletem a melhora na tolerância ao exercício e na dispnéia em resposta a broncodilatador em doenças pulmonares obstrutivas. Métodos: 50 pacientes com DPOC e/ou asma (VEF 1 /CVF = 41 ± 11%) realizaram manobras de CV lenta e forçada, VVM e um teste de caminhada em corredor de seis minutos após treinamento, antes e após salbutamol, 400mcg fornecido por spray com espaçador. As respostas a broncodilatador foram expressas em valores absolutos, como incremento em relação ao valor inicial e em relação aos valores previstos. Resposta após Bd foi considerada clinicamente significante quando a distância percorrida se elevou 30m ou mais e/ou a dispnéia foi reduzida dois ou mais pontos com qualquer aumento na caminhada. Resultados: 32 pacientes foram considerados respondedores (R) e 18 não respondedores (NR). Como a distância caminhada em seis minutos se correlacionou com a idade (rs = -0,38; p < 0,01), análise dos dados espirométricos foi realizada incluindo a idade como covariada e expressa como x ± EPE. O incremento do VEF 1 não diferiu nos dois grupos: R = 255 ± 57ml, NR = 256 ± 43ml. Idem para a VVM: R = 11 ± 2L/min, NR = 10 ± 2L/min.A melhor separação (p < 0,01) foi dada pela mudança da capacidade inspiratória (CI) seguida da mudança da capacidade vital lenta (CV): CI% da inicial nos R = 23 ± 3% e os NR = 3 ± 4%; CI absoluta: R = 411 ± 58ml, NR = 163 ± 77ml; CI% previsto: R = 19 ± 3% e NR = 3 ± 4%. Para a CV os valores observados foram: CV% do inicial -R = 18 ± 2% e NR = 9 ± 3%; CV absoluta -R = 448 ± 52ml e NR = 256 ± 70ml. Incrementos para a CI > 15% do inicial e 0,3L e da CV > 15% da inicial e 0,4L separaram os respondedores com valor preditivo positivo (VPP) em torno de 90%. Conclusão: A melhora do VEF 1 , CVF e VVM não prediz melhora na capacidade de exercício após Bd. Esta é melhor refletida por aumentos na CI e/ou CV Recebido para publicação em 7/4/00. Aprovado, após revisão, em 24/10/00.

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Section: ) Bds E Volumes Pulmonaresunclassified

“…Este achado pode ocorrer na ausência de mudança no VEF 1 (resposta isolada de volume) e se correlaciona com redução da dispnéia (14)(15)(16)(17)(18) . O teste de caminhada de seis minutos ganhou larga aceitação como um teste simples para avaliar o desempenho de exercício em DPOC.…”

Section: Introductionunclassified

Resposta a broncodilatador na espirometria: que parâmetros e valores são clinicamente relevantes em doenças obstrutivas?

Rodrigues

Pereira

2001

J. Pneumologia

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“…Lung function measured during tidal breathing undergoes substantial changes after 132-agonist inhalation in some patients. However, in spite of only small changes in FEV1.0 or PEF [2], the decrease in residual volume (RV), the increase in forced vital capacity (FVC), and specific conductance (s-Gaw) may be clinically significant. Patients with severe airflow obstruction increase their respiratory rate even at light physical activity, for example, climbing stairs, etc., which causes an increased hyperinflation [7].…”

Section: Introductionmentioning

confidence: 99%

Terbutaline in COPD comparison between turbuhaler� and chlorofluorocarbon (CFC) inhaler

Formgren

Sjökvist²,

Ståhl³

et al. 1994

Lung

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Patients with chronic obstructive pulmonary disease (COPD) often subjectively benefit from inhaled beta 2-agonists in spite of little or no demonstrable effect in forced expiratory volume in 1 second (FEV1.0). A comparison between the effects of terbutaline administered via a dry powder inhaler (Turbuhaler) and via a chlorofluorocarbon (CFC) inhaler in conjunction with a spacer device (Nebuhaler) was performed in patients with regard to FEV1.0, forced expiratory capacity (FVC), residual volume (RV), and specific conductance (s-Gaw). Fifteen hospitalised patients (11 male) with COPD were studied, each of whom had a diurnal variation in peak expiratory flow (PEF) not exceeding 15% and with a demonstrated volume response to inhaled beta 2-agonists in FVC and/or RV of at least 15%. Patients were administered each of the following five treatments on a single occasion in a randomized order (latin square) in intervals of at least 2 days: placebo, terbutaline via Turbuhaler (1.0 and 2.5 mg) and terbutaline via a CFC inhaler (1.0 mg without and 2.5 mg with Nebuhaler). Inhalation of terbutaline in different doses and from different devices induced a decrease in RV, an increase in FVC, and s-Gaw and a less pronounced increase in FEV1.0. No statistically significant differences between the four terbutaline treatments were seen, but all were significantly different from the placebo. These findings indicate that while patients with COPD may benefit from inhaled terbutaline through decreased hyperinflation, the choice of inhalation device seems to be of little importance for its efficacy.

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“…This is not surprising since it has been shown that FEV 1 is not as sensitive as FVC or RVC in detecting reversibility in patients with COPD [24][25][26][27]. In addition the low absolute values of FEV 1 in ) with the exception of Borg scores, and activity scores given as medians and interquartile ranges "Indicates a significant difference from mianserin; b indicates a significant difference from placebo these patients and the consequent large variability will make statistically significant differences more difficult to detect.…”

Section: Discussionmentioning

confidence: 99%

A comparison of the effects of prednisolone and mianserin on ventilatory, exercise and psychometric parameters in patients with chronic obstructive pulmonary disease

Grove

Lipworth

Ingram

et al. 1995

Eur J Clin Pharmacol

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There is controversy as to whether effects on mood play a role in mediating the response to corticosteroids in chronic obstructive pulmonary disease (COPD). If alterations in mood are important, it is conceivable that psychotropic drugs such as mianserin might produce similar responses to prednisolone in patients with COPD. Twelve patients age 62.5 y, with FEV1 29% of predicted and < 15% reversibility to salbutamol completed a randomised, double-blind crossover study. After an initial three week placebo run-in period patients received three weeks of prednisolone 40 mg daily or mianserin 60-90 mg daily with an intervening three week placebo washout period. Full respiratory function tests, bicycle ergometry and 6 minute walks were performed before and after the run-in and at the end of each period. Psychological and functional assessments were also made at each visit. Prednisolone significantly increased FVC, maximum ventilation (VEmax) and maximum heart rate (HRmax) compared with placebo, with mean for the difference of 0.25 l, 2.56 l.min-1 and 12 beats.min-1 respectively. FVC, maximum oxygen uptake (VO2max) and HRmax were also significantly increased with prednisolone compared with mianserin. Anxiety scores were significantly lower with prednisolone compared with placebo. In contrast, mianserin had no significant effects on lung function, exercise or psychological parameters compared with placebo. The improvements in ventilation, exercise and anxiety scores following treatment with prednisolone were not reproduced by mianserin, suggesting that the effects of prednisolone in COPD are unlikely to be due to alterations in mood.

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The effects of salbutamol aerosol on lung function in patients with pulmonary emphysema

Cited by 39 publications

References 7 publications

Resposta a broncodilatador na espirometria: que parâmetros e valores são clinicamente relevantes em doenças obstrutivas?

Resposta a broncodilatador na espirometria: que parâmetros e valores são clinicamente relevantes em doenças obstrutivas?

Terbutaline in COPD comparison between turbuhaler� and chlorofluorocarbon (CFC) inhaler

A comparison of the effects of prednisolone and mianserin on ventilatory, exercise and psychometric parameters in patients with chronic obstructive pulmonary disease

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