Reversibility with bronchodilator treatment in pulmonary function testing is used to identify patients who may respond to steroids.About 30% of patients with COPD show reversibility when tested with bronchodilators in PFT. We wanted to study if any additional bronchodilator effect was seen when ipratropium was combined with albuterol.METHOD: 21 patients with clinical diagnosis of COPD were chosen.The average FEV1 was 1.08±0.45.On day1 spirometry was performed before and 30 minutes after albuterol nebulisation(2.5g/3ml(0.083%)).On day 7 spirometry was performed before and 30 minutes after treatment with combination of same dose of albuterol and ipratropium bromide (0.5g/2.5 ml (0.02%)).
A total of 10(47%)patients showed significant (≥12% and at least 200 ml) bronchodilator response with either of the regimens. (p<.01). 4 patients (19% of the study group) showed significant bronchodilator response to the combination alone without any significant response when just albuterol was used. 1 patient showed significant bronchodilator response with albuterol and failed to demonstrate bronchodilator response with the combination of atrovent and albuterol. 5 patients showed significant bronchodilator response to both regimens.
Use of atrovent and albuterol combination for assessing reversibility in PFT for COPD patients does increase the detection of bronchodilator response.CLINICAL IMPLICATION: There is benefit of adding ipratropium to albuterol in testing for reversibility in pulmonary function in patients with COPD, as it may help in unmasking bronchodilator response in some patients,therby facilitating optimal treatment.
L. Kasirajan, None.