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Obstructive Lung Diseases: COPD I |

Efficiency of Neural Respiratory Drive for the Assessment of Bronchodilator Responsiveness in Patients With Chronic Obstructive Pulmonary Disease: An Exploratory Study FREE TO VIEW

Xin Chen, MD; Yun Li; Yin-huan Li; Yu-wen Luo; Yu-xia Huang
Author and Funding Information

Southern Medical University, Guangzhou, China


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A375. doi:10.1016/j.chest.2016.02.390
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SESSION TITLE: COPD I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Conventional lung function parameters, such as forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and inspiratory capacity (IC) are often used to assess the therapeutic outcomes of bronchodilators, but they lack sensitivity. A novel indicator, namely efficiency of neural respiratory drive (NRD), may objectively evaluate the physiological changes in patients with chronic obstructive pulmonary disease (COPD). We investigated whether this indicator could be used to more accurately assess the responsiveness to inhaled bronchodilators.

METHODS: Thirty-six subjects with moderate-to-severe COPD were randomized into Group A (n=18) and Group B (n=18). Participants in Group A inhaled 400 μg placebo, 400 μg 400 μg salbutamol and 80 μg ipratropium in sequence whereas those in Group B had the salbutamol and ipratropium reversed. At different time points after administration of placebo or bronchodilators, evaluated indices included FEV1, FVC, IC, root mean square (RMS) of diaphragm electromyogram, and efficiency of NRD (herein defined as the ratio of minute ventilation (VE) to RMS, or VE/RMS).

RESULTS: FEV1, FVC, IC, RMS, and VE/RMS significantly improved after inhaled bronchodilators and VE/RMS had the largest improvement among five indices. The detection efficiency of VE/RMS was greater than FEV1, FVC, IC (all P<0.05), but not different from RMS. The accuracy and sensitivity of VE/RMS were significantly higher than FEV1, FVC, IC, and RMS (all P<0.05).

CONCLUSIONS: Efficiency of NRD may be a sensitive tool to evaluate the efficacy of inhaled bronchodilators in COPD.

CLINICAL IMPLICATIONS: Proper evaluation of the response to bronchodilator therapy is crucial for clinical management of severe COPD. Herein, we evaluated a novel indicator of therapeutic responsiveness to fast-acting inhaled bronchodilators in COPD patients. This indicator, the ratio of ventilation to the root mean square of the diaphragm electromyogram, termed VE/RMS, was found to be more sensitive and accurate than other more traditional lung function parameters, such as FEV1.

DISCLOSURE: Xin Chen: Grant monies (from sources other than industry): the Guangdong Provincial Science and Technology Project (A2013137 and 2013B022000072) Yun Li: Grant monies (from sources other than industry): the Guangdong Provincial Science and Technology Project (A2013137 and 2013B022000072) Yin-huan Li: Grant monies (from sources other than industry): the Guangdong Provincial Science and Technology Project (A2013137 and 2013B022000072) Yu-wen Luo: Grant monies (from sources other than industry): the Guangdong Provincial Science and Technology Project (A2013137 and 2013B022000072) Yu-xia Huang: Grant monies (from sources other than industry): the Guangdong Provincial Science and Technology Project (A2013137 and 2013B022000072)

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