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Obstructive Lung Diseases: COPD Pharmacotherapy |

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 FREE TO VIEW

Yun Li, MMSc; Xin Chen, MD; Yin-huan Li, MD; Yu-wen Luo; Rui Xiao
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Southern Medical University, Guangzhou, China


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


Chest. 2016;149(4_S):A389. doi:10.1016/j.chest.2016.02.404
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SESSION TITLE: COPD Pharmacotherapy

SESSION TYPE: Original Investigation Poster

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

PURPOSE: 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).

METHODS: Thirty moderate-to-severe COPD patients were randomized into three groups: placebo group (n=10), monotherapy group (salbutamol, n=10), and combined therapy group (salbutamol and ipratropiumin, n=10). Each subject initially performed MIV for three minutes at baseline, and then repeated 3-min MIV 30 minutes after inhaled placebo 400μg, or salbutamol 400μg, or combined inhalation of salbutamol 400μg and ipratropium 80μg, based on the group. The parameters of diaphragm function and neural respiratory drive were monitored continuously and calculated during MIV.

RESULTS: During MIV, all groups experienced a linear increase in root mean square (RMS) of diaphragm electromyogram but showed gradual decrease in transdiaphragmatic pressure (Pdi), minute ventilation (VE) and VE/RMS. After inhalation of the corresponding drugs, the parameters of placebo group had no significant change while those of both monotherapy group and combined therapy group improved significantly. In comparison with placebo group, the values of Pdi and VE in the latter two groups at the same time point increased significantly, and those of RMS and Borg score decreased significantly, thus increasing VE/RMS (all P<0.05). No significant difference in all indices was found between monotherapy group and combined therapy group (all P>0.05). The ▵Borg was significantly correlated with ▵Pdi, ▵VE, ▵RMS, and ▵VE/RMS, respectively (all P<0.05).

CONCLUSIONS: Inhaled short-acting bronchodilators can alleviate the diaphragm fatigue of COPD patients during MIV, increase lung ventilation, reduce neural respiratory drive, and improve neuro-ventilatory coupling, which might underlie the reduction of dyspnoea in COPD patients.

CLINICAL IMPLICATIONS: The present study showed inhaled short-acting bronchodilators can help alleviate the diaphragm fatigue of COPD patients.

DISCLOSURE: Yun Li: Grant monies (from sources other than industry): The Guangzhou Municipal Science and Technology Project (201300000171) Xin Chen: Grant monies (from sources other than industry): The Guangzhou Municipal Science and Technology Project (201300000171) Yin-huan Li: Grant monies (from sources other than industry): The Guangzhou Municipal Science and Technology Project (201300000171) Yu-wen Luo: Grant monies (from sources other than industry): The Guangzhou Municipal Science and Technology Project (201300000171) Rui Xiao: Grant monies (from sources other than industry): The Guangzhou Municipal Science and Technology Project (201300000171)

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