Effects of inhaled short-acting bronchodilators on diaphragm function and neural respiratory drive during maximal isocapnic ventilation in patients with chronic obstructive pulmonary disease / 南方医科大学学报
Journal of Southern Medical University
;
(12): 232-237, 2016.
Article
Dans Chinois
| WPRIM
| ID: wpr-264065
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of inhaled short-acting bronchodilators on diaphragm function and neural respiratory drive in patients with chronic obstructive pulmonary disease (COPD) during maximal isocapnic ventilation (MIV).</p><p><b>METHODS</b>Forty-seven patient with moderate to severe COPD were randomized into 4 groups placebo group (n=12), salbutamol group (n=13), ipratropium group (n=10), and combined group (salbutamol and ipratropium, n=12). Each subject received an initial MIV for 3 min at baseline and inhaled placebo (400 µg), salbutamol (400 µg), ipratropium (80 µg), or both salbutamol and ipratropium, followed 30 min later by another 3 min of MIV. The parameters of diaphragm function and neural respiratory drive were monitored continuously and calculated during MIV.</p><p><b>RESULTS</b>During the initial MIV, all the patients experienced a linear increase in root mean square (RMS) of diaphragm electromyogram with a gradual decrease in transdiaphragmatic pressure (Pdi), minute ventilation (VE), and VE/RMS, and these parameters all improved significantly after inhalation of the bronchodilators. Compared with the placebo group at the same time point, the 3 bronchodilator-treated groups showed significantly decreased RMS and Borg score and increased Pdi, VE and VE/RMS; VE/RMS was the highest in the combined treatment group (P<0.05). The Delta Borg was significantly correlated with Delta Pdi, Delta VE, Delta RMS, and Delta VE/RMS (P<0.05).</p><p><b>CONCLUSIONS</b>In COPD patients, inhaled short-acting bronchodilators can alleviate diaphragm fatigue during MIV, increase lung ventilation, reduce neural respiratory drive, and improve neuro-ventilatory coupling to relieve dyspnoea, and the combination of β-2 agonists and anti-muscarinic antagonists produces a stronger efficacy.</p>
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Respiration
/
Administration par inhalation
/
Bronchodilatateurs
/
Muscle diaphragme
/
Ipratropium
/
Broncho-pneumopathie chronique obstructive
/
Utilisations thérapeutiques
/
Salbutamol
/
Traitement médicamenteux
Type d'étude:
Essai clinique contrôlé
Limites du sujet:
Humains
langue:
Chinois
Texte intégral:
Journal of Southern Medical University
Année:
2016
Type:
Article
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