PURPOSE: To conduct a comparative evaluation of the efficacy of percutaneous electrostimulation of the diaphragm versus pharmacologic treatment with etimyzole for improving inspiratory respiratory muscular function in patients with COPD.
METHODS: 58 patients with COPD were enrolled in this study. The reversibility of obstruction was established through pre- and post-beta agonist (salbutamol, berotek) pulmonary function testing. Post-beta agonist testing was performed 20 minutes after inhalation. An increase in flow indicators of lung capacity and expiration velocity per 1 sec. of 12% or more was considered as a reliable indicator of reversibility. Diaphragm fatigue was calculated by the discriminate equation: F=17.3 × FEF50. Diaphragm fatigue was diagnosed based on F<65.1. All patients who met criteria for diaphragm fatigue received standard therapy for COPD. Patients were randomly assigned for treatment with either daily electrostimulation of the diaphragm for 6-8 days (28 patients) or treatment with etimyzole in a dose of 100 mg p.o. 3-4 times per day after meals for 10-20 days(30 patients).
RESULTS: Patients in this study who were randomized to treatment with etimyzole demonstrated greater improvement in inspiratory muscular function than the patients who received electrostimulation treatment.
CONCLUSION: Medical therapy with etimyzole may be successfully used in the treatment of patients with COPD and fatigue of inspiratory respiratory musculature. Etimyzole appears to be superior to electrical stimulation of the diaphragm for improving respiratory function.
CLINICAL IMPLICATIONS: Etimyzole therapy may have a role in reducing inspiratory musculature fatigue in patients with COPD. Further testing is needed to establish the long-term efficacy and also to establish a potential benefit of etimyzole treatment used in combination with electrical stimulation therapy.
DISCLOSURE: Nodira Zoirova, None.