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Acute bronchodilator therapy does not reduce wasted ventilation during exercise in COPD.
Elbehairy, Amany F; Webb, Katherine A; Laveneziana, Pierantonio; Domnik, Nicolle J; Neder, J Alberto; O'Donnell, Denis E.
Afiliación
  • Elbehairy AF; Department of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada; Department of Chest Diseases, Faculty of Medicine, Alexandria University, Alexandria, Egypt; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, UK.
  • Webb KA; Department of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada.
  • Laveneziana P; Sorbonne Universités, UPMC Université Paris 06, INSERM, UMRS_1158 Neurophysiologie respiratoire expérimentale et Clinique, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspn
  • Domnik NJ; Department of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada.
  • Neder JA; Department of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada.
  • O'Donnell DE; Department of Medicine, Queen's University and Kingston Health Sciences Centre, Kingston, ON, Canada. Electronic address: odonnell@queensu.ca.
Respir Physiol Neurobiol ; 252-253: 64-71, 2018 06.
Article en En | MEDLINE | ID: mdl-29578103
This randomized, double-blind, crossover study aimed to determine if acute treatment with inhaled bronchodilators, by improving regional lung hyperinflation and ventilation distribution, would reduce dead space-to-tidal volume ratio (VD/VT); thus contributing to improved exertional dyspnea in COPD. Twenty COPD patients (FEV1 = 50 ±â€¯15% predicted; mean ±â€¯SD) performed pulmonary function tests and symptom-limited constant-work rate exercise at 75% peak-work rate (with arterialized capillary blood gases) after nebulized bronchodilator (BD; ipratropium 0.5mg + salbutamol 2.5 mg) or placebo (PL; normal saline). After BD versus PL: Functional residual capacity decreased by 0.4L (p = .0001). Isotime during exercise after BD versus PL (p < .05): dyspnea decreased: 1.2 ±â€¯1.9 Borg-units; minute ventilation increased: 3.8 ±â€¯5.5 L/min; IC increased: 0.24 ±â€¯0.28 L and VT increased 0.19 ±â€¯0.16 L. There was no significant difference in arterial CO2 tension or VD/VT, but alveolar ventilation increased by 3.8 ±â€¯5.5 L/min (p = .02). Post-BD improvements in respiratory mechanics explained 51% of dyspnea reduction at a standardized exercise time. Bronchodilator-induced improvements in respiratory mechanics were not associated with reduced wasted ventilation - a residual contributory factor to exertional dyspnea during exercise in COPD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Respiración / Broncodilatadores / Ejercicio Físico / Enfermedad Pulmonar Obstructiva Crónica Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Respir Physiol Neurobiol Año: 2018 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Respiración / Broncodilatadores / Ejercicio Físico / Enfermedad Pulmonar Obstructiva Crónica Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Respir Physiol Neurobiol Año: 2018 Tipo del documento: Article Pais de publicación: Países Bajos