Effect of albuterol on expiratory resistance in mechanically ventilated patients.

Abstract:

BACKGROUND:In mechanically ventilated patients with COPD, the response of the expiratory resistance of the respiratory system (expiratory R(RS)) to bronchodilators is virtually unknown. OBJECTIVE:To examine the effect of inhaled albuterol on expiratory R(RS), and the correlation of albuterol-induced changes in expiratory R(RS) with end-inspiratory resistance and the expiratory flow-volume relationship. METHODS:We studied 10 mechanically ventilated patients with COPD exacerbation, before and 30 min after administration of albuterol. We obtained flow-volume curves during passive expiration, divided the expired volume into 5 equal volume slices, and then calculated the time constant and dynamic effective deflation compliance of the respiratory system (effective deflation C(RS)) of each slice via regression analysis of the volume-flow and post-occlusion volume-tracheal pressure relationships, respectively. For each slice we calculated expiratory R(RS) as the time constant divided by the effective deflation C(RS). RESULTS:Albuterol significantly decreased the expiratory R(RS) (mean expiratory R(RS) 42.68 ± 17.8 cm H(2)O/L/s vs 38.08 ± 16.1 cm H(2)O/L/s) and increased the rate of lung emptying toward the end of expiration (mean time constant 2.51 ± 1.2 s vs 2.21 ± 1.2 s). No correlation was found between the albuterol-induced changes in expiratory R(RS) and that of end-inspiratory resistance. Only at the end of expiration did albuterol-induced changes in the expiratory flow-volume relationship correlate with changes in expiratory R(RS) in all patients. CONCLUSIONS:In patients with COPD, albuterol significantly decreases expiratory resistance at the end of expiration. In mechanically ventilated patients, neither inspiratory resistance nor the whole expiratory flow-volume curve may be used to evaluate the bronchodilator response of expiratory resistance.

journal_name

Respir Care

journal_title

Respiratory care

authors

Kondili E,Alexopoulou C,Prinianakis G,Xirouchaki N,Vaporidi K,Georgopoulos D

doi

10.4187/respcare.00984

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

626-32

issue

5

eissn

0020-1324

issn

1943-3654

pii

rc00984r2kondili

journal_volume

56

pub_type

杂志文章
  • Tuberculosis-associated secondary pneumothorax: a retrospective study of 53 patients.

    abstract:BACKGROUND:Pneumothorax is a well known complication of pulmonary tuberculosis (TB), particularly in patients with advanced TB. METHODS:At our national TB-referral hospital, we compared the medical records of 53 TB patients with pneumothorax and 106 TB patients without pneumothorax, seen in 2003 to 2008. We analyzed d...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.00695

    authors: Shamaei M,Tabarsi P,Pojhan S,Ghorbani L,Baghaei P,Marjani M,Masjedi MR

    更新日期:2011-03-01 00:00:00

  • Heliox and forward-leaning posture improve the efficacy of nebulized bronchodilator in acute asthma: a randomized trial.

    abstract:BACKGROUND:Heliox and forward-leaning posture (torso inclined forward at 50-60° with the elbows resting on the thighs) are adjuncts in the administration of nebulized bronchodilator to patients with acute asthma. METHODS:We randomized 59 patients who presented to the emergency department in severe asthma crisis, into ...

    journal_title:Respiratory care

    pub_type: 杂志文章,随机对照试验

    doi:10.4187/respcare.00963

    authors: Brandão DC,Britto MC,Pessoa MF,de Sá RB,Alcoforado L,Matos LO,Silva TN,de Andrade AD

    更新日期:2011-07-01 00:00:00

  • Increased Accuracy After Adjustment of Spirometry Threshold for Diagnosing COPD Based on Pre-Bronchodilator FEV1/FVC.

    abstract:BACKGROUND:COPD is a leading cause of morbidity and mortality worldwide. Spirometry is the most common lung function test for diagnosing COPD with a post-bronchodilator FEV1/FVC < 0.70 confirming the presence of the disease. However, diagnosticians appear reluctant to use bronchodilators, which have been linked to the ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.06148

    authors: Kronborg T,Hangaard S,Cichosz SL,Hejlesen O

    更新日期:2019-01-01 00:00:00

  • Coexistence of bronchiectasis and rheumatoid arthritis: revisited.

    abstract::The presence of bronchiectasis (BR) in patients with rheumatoid arthritis (RA) has been recognized for many decades; nevertheless, little research has been undertaken in this area. It is important to recognize that BR coexistent with RA differs from the other types of BR. The purpose of this descriptive review was to ...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.01857

    authors: Wilczynska MM,Condliffe AM,McKeon DJ

    更新日期:2013-04-01 00:00:00

  • Sleep-disordered breathing may be under-recognized in patients who wean from prolonged mechanical ventilation.

    abstract:BACKGROUND:The prevalence of sleep-disordered breathing (SDB) in patients with prolonged mechanical ventilation (PMV) is unknown. The aim of this study was to assess the frequency of SDB in patients admitted to a long-term acute care (LTAC) hospital who weaned from PMV. METHODS:Retrospective chart review was conducte...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.01260

    authors: Diaz-Abad M,Verceles AC,Brown JE,Scharf SM

    更新日期:2012-02-01 00:00:00

  • Strategies for screening for chronic obstructive pulmonary disease.

    abstract::Chronic obstructive pulmonary disease is easily detected in its preclinical phase, using office spirometry. Successful smoking cessation prevents further disease progression in most patients. Spirometry measures the ratio of the forced expiratory volume in the first second to the forced vital capacity (FEV(1)/FVC), wh...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:

    authors: Enright PL,Kaminsky DA

    更新日期:2003-12-01 00:00:00

  • Sleep-disordered breathing and COPD: the overlap syndrome.

    abstract::Sleep-disordered breathing (mainly obstructive sleep apnea [OSA]) and COPD are among the most common pulmonary diseases, so a great number of patients have both disorders; this "overlap syndrome" causes more severe nocturnal hypoxemia than either disease alone. This common combination of OSA and COPD has important imp...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:

    authors: Owens RL,Malhotra A

    更新日期:2010-10-01 00:00:00

  • Reduced Diaphragm Excursion During Reflexive Citric Acid Cough Test in Subjects With Subacute Stroke.

    abstract:BACKGROUND:Diaphragm excursion is limited during respiratory maneuvers after a stroke. How the diaphragm is limited during reflexive coughs and affects the effectiveness of cough in stroke patients is unclear. This study aimed to measure reflexive cough strength by cough peak flow (CPF) induced by citric acid nebulizat...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.05488

    authors: Choi YM,Park GY,Yoo Y,Sohn D,Jang Y,Im S

    更新日期:2017-12-01 00:00:00

  • Devices Used for CPAP Delivery.

    abstract::CPAP is a spontaneous mode of ventilation that maintains a constant airway pressure during the inspiratory and expiratory phases. This therapeutic modality is used across the continuum of care from pre-hospital treatment to intensive and acute care units to the home care environment to treat a host of acute and chroni...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.06625

    authors: Volsko TA

    更新日期:2019-06-01 00:00:00

  • Management of acute lung injury: sharing data between adults and children.

    abstract::As the basis for this paper, it must be acknowledged that children are not simply small adults. But this acknowledgment must go further: infants are not simply small adolescents. As data for pediatric mechanical ventilation, in general, and the management for pediatric acute lung injury, more specifically, are very l...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.01413

    authors: Cheifetz IM

    更新日期:2011-09-01 00:00:00

  • Distance learning and the internet in respiratory therapy education.

    abstract:BACKGROUND:The profession of respiratory therapy (RT) continues to grow both in number, due to population growth and an ever-increasing aging population, and scope of practice, due to both new and expanded roles and responsibilities in divergent areas of clinical practice. Instructional technology, including distance ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.01197

    authors: Varekojis SM,Sergakis GG,Dunlevy CL,Foote E,Clutter J

    更新日期:2011-11-01 00:00:00

  • Response to albuterol MDI delivered through an anti-static chamber during nocturnal bronchospasm.

    abstract:BACKGROUND:Decreasing electrostatic charge on valved holding chambers increases the amount of drug delivered. However, there are no data demonstrating that this increases bronchodilatation. OBJECTIVE:To investigate the influence of reducing electrostatic charge on the bronchodilator response to albuterol inhaler duri...

    journal_title:Respiratory care

    pub_type: 杂志文章,随机对照试验

    doi:10.4187/respcare.01572

    authors: Prabhakaran S,Shuster J,Chesrown S,Hendeles L

    更新日期:2012-08-01 00:00:00

  • 2019 Year in Review: Neonatal Respiratory Support.

    abstract::Respiratory support of the critically ill neonate has steadily shifted from invasive to noninvasive forms of support. There have recently been a number of important advances in our understanding of the changes to neonatal resuscitation practices as they pertain to clinically important outcomes, mechanisms of gas excha...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.07720

    authors: Wheeler CR,Smallwood CD

    更新日期:2020-05-01 00:00:00

  • Impulse oscillometry for leukotriene D4 inhalation challenge in asthma.

    abstract:BACKGROUND:The value of impulse oscillometry (IOS) for bronchial provocation testing is poorly defined. We investigated the positive threshold derived from the parameters and diagnostic power of IOS for asthma with the leukotriene D(4) bronchial provocation test. METHODS:We enrolled 62 subjects with asthma and 21 heal...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.02417

    authors: Guan WJ,Zheng JP,Gao Y,Jiang CY,Shi X,Xie YQ,Liu QX,Jiang M,An JY,Yu XX,Liu WT,Zhong LP,Wu ZP,Zhong NS

    更新日期:2013-12-01 00:00:00

  • Humidification Performance of Passive and Active Humidification Devices Within a Spontaneously Breathing Tracheostomized Cohort.

    abstract:BACKGROUND:Most heat-and-moisture exchangers (HMEs) for patients with tracheostomy and spontaneously breathing are small and have suction ports that allow some expiratory gas to escape, which loses water vapor held in the expired gas. Recently, a heated-and-humidified high-flow system for spontaneously breathing patien...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.06294

    authors: Nakanishi N,Oto J,Itagaki T,Nakataki E,Onodera M,Nishimura M

    更新日期:2019-02-01 00:00:00

  • Noninvasive ventilation for acute respiratory failure: a national survey of Veterans Affairs hospitals.

    abstract:BACKGROUND:The utilization of noninvasive ventilation (NIV) in the Veterans Affairs health-care system is not well characterized. A survey of physicians and respiratory therapists was conducted to better understand its use. METHODS:Three hospitals in each of 21 Veterans Affairs networks were selected based on severity...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Bierer GB,Soo Hoo GW

    更新日期:2009-10-01 00:00:00

  • Cough Augmentation Techniques in the Critically Ill: A Canadian National Survey.

    abstract:BACKGROUND:Critically ill mechanically ventilated patients experience impaired airway clearance due to ineffective cough and impaired secretion mobilization. Cough augmentation techniques, including mechanical insufflation-exsufflation (MI-E), manually assisted cough, and lung volume recruitment, improve cough efficien...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.04775

    authors: Rose L,Adhikari NK,Poon J,Leasa D,McKim DA,CANuVENT Group.

    更新日期:2016-10-01 00:00:00

  • An unusual cause of refractory hypoxemia in cirrhosis.

    abstract::Pulmonary gas exchange abnormalities and refractory hypoxemia cause myriad difficulties in patients with chronic liver disease. In addition to intrinsic cardiopulmonary diseases and hepatopulmonary syndrome, some unusual pathophysiological mechanisms in patients with portosystemic collaterals might contribute to hypox...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.03529

    authors: Patidar Y,Kumar S

    更新日期:2015-03-01 00:00:00

  • Value of Plethysmographic Pulse Amplitude Ratio With Valsalva Maneuver in Identifying Left Ventricular Dysfunction During COPD Exacerbation.

    abstract:BACKGROUND:Left-ventricular dysfunction associated with COPD exacerbation is frequently underestimated. We tested whether finger plethysmography waveform change during the Valsalva maneuver could aid in the distinction between patients with COPD exacerbation with and without left-ventricular dysfunction. METHODS:We in...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.04091

    authors: Boubaker H,Grissa MH,Debbabi H,Beltaief K,Dridi Z,Najjar MF,Bouida W,Boukef R,Marghli S,Nouira S

    更新日期:2016-04-01 00:00:00

  • Interleukin 27 could be useful in the diagnosis of tuberculous pleural effusions.

    abstract:BACKGROUND:The diagnosis of tuberculous pleural effusion (TBPE) has some limitations. We studied the efficacy of interleukin-27 (IL-27) in the diagnosis of TBPE. METHODS:We measured IL-27, adenosine deaminase (ADA), ADA-2, interferon-gamma (IFNγ), and the ADA·IL-27 and ADA-2·IL-27 products in all the pleural effusion ...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.02749

    authors: Valdés L,San José E,Ferreiro L,Golpe A,Gude F,Álvarez-Dobaño JM,Pereyra MF,Toubes ME,González-Barcala FJ

    更新日期:2014-03-01 00:00:00

  • Calculation of physiologic dead space: comparison of ventilator volumetric capnography to measurements by metabolic analyzer and volumetric CO2 monitor.

    abstract:BACKGROUND:Calculation of physiologic dead space (dead space divided by tidal volume [VD/VT]) using the Enghoff modification of the Bohr equation requires measurement of the partial pressure of mean expired CO2 (PĒCO2) by exhaled gas collection and analysis, use of a metabolic analyzer, or use of a volumetric CO2 monit...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.02116

    authors: Siobal MS,Ong H,Valdes J,Tang J

    更新日期:2013-07-01 00:00:00

  • Effect of a Motivational Interviewing-Based Health Coaching on Quality of Life in Subjects With COPD.

    abstract:BACKGROUND:Improving quality of life (QOL) is a key goal in the care of patients with COPD. Pulmonary rehabilitation (PR) has clearly been shown to improve QOL, but is not accessible to many eligible patients. There is a need for alternative programs designed to improve patient well-being that are accessible to all pat...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.04984

    authors: Rehman H,Karpman C,Vickers Douglas K,Benzo RP

    更新日期:2017-08-01 00:00:00

  • High-Flow Nasal Cannula in a Mixed Adult ICU.

    abstract:BACKGROUND:Humidified, high-flow nasal cannula (HFNC) enables mucociliary clearance, accurate oxygen measurement, precise control of flow, and low-level positive airway pressure. There is sparse information concerning the timing of HFNC on patient outcomes such as incidence of adverse events during hospitalization, ICU...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.04016

    authors: Gaunt KA,Spilman SK,Halub ME,Jackson JA,Lamb KD,Sahr SM

    更新日期:2015-10-01 00:00:00

  • Comparison of sampler filling times among selected arterial blood samplers.

    abstract:BACKGROUND:True arterial blood samples are essential in making clinical decisions for respiratory patients. Previous studies using only the Portex Pro-Vent arterial sampler have shown a significant difference between arterial and venous filling times. The goal of this study was to determine whether there is a statistic...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.03480

    authors: McMillen CN,Adu-Yeboah S,Kagarise E,Morton RL,Yuce B,Douce FH

    更新日期:2015-04-01 00:00:00

  • Work of breathing in adaptive pressure control continuous mandatory ventilation.

    abstract:BACKGROUND:Adaptive pressure control is a mode of mechanical ventilation where inflation pressure is adjusted by the ventilator to achieve a target tidal volume (VT). This means that as patient effort increases, inflation pressure is reduced, which may or may not be clinically appropriate. The purpose of this study was...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Mireles-Cabodevila E,Chatburn RL

    更新日期:2009-11-01 00:00:00

  • The importance of nonelectrostatic materials in holding chambers for delivery of hydrofluoroalkane albuterol.

    abstract:INTRODUCTION:Electrostatic attraction of aerosolized particles to the inner walls of an aerosol holding chamber (HC) made from a nonconducting material can reduce medication delivery, particularly if there is a delay between actuation and inhalation. OBJECTIVE:Compare total emitted mass and fine-particle mass (mass of...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:

    authors: Rau JL,Coppolo DP,Nagel MW,Avvakoumova VI,Doyle CC,Wiersema KJ,Mitchell JP

    更新日期:2006-05-01 00:00:00

  • Effectiveness of a Pulmonary Rehabilitation Program on Persistent Asthma Stratified for Severity.

    abstract:BACKGROUND:Asthma is defined by airway inflammation associated with various respiratory symptoms, and pharmacologic treatment is based on inhaled corticosteroids and bronchodilators. Physical activity, educational training, nutritional support, and psychological counseling are considered part of non-pharmacologic treat...

    journal_title:Respiratory care

    pub_type: 杂志文章

    doi:10.4187/respcare.06761

    authors: Zampogna E,Paneroni M,Cherubino F,Pignatti P,Rudi M,Casu G,Vitacca M,Spanevello A,Visca D

    更新日期:2019-12-01 00:00:00

  • Metabolic and nutrition support in the chronic critical illness syndrome.

    abstract::Technological innovations in the ICU have led to artificially prolonged life, with an associated cost. Chronic critical illness (CCI) occurs in patients with prolonged mechanical ventilation and allostatic overload, and is associated with a discrete and consistent metabolic syndrome. Metabolic interventions are extra...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.01620

    authors: Schulman RC,Mechanick JI

    更新日期:2012-06-01 00:00:00

  • Noninvasive ventilation in neuromuscular disease: equipment and application.

    abstract::Noninvasive support of ventilation is commonly needed in patients with neuromuscular disease. Body ventilators, which are used rarely, function by applying intermittent negative pressure to the thorax or abdomen. More commonly, noninvasive positive-pressure ventilation (NPPV) is used. This therapy can be applied with ...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:

    authors: Hess DR

    更新日期:2006-08-01 00:00:00

  • Year in Review 2018: Pediatric Mechanical Ventilation.

    abstract::Mechanical ventilation is frequently used in pediatric patients to ensure adequate gas exchange, ameliorate respiratory distress, and enable resolution of pulmonary or other disorders. However, a number of important challenges remain in the pediatric population because there is a paucity of large-scale randomized cont...

    journal_title:Respiratory care

    pub_type: 杂志文章,评审

    doi:10.4187/respcare.07029

    authors: Smallwood CD,Davis MD

    更新日期:2019-07-01 00:00:00