Journal article
A randomized, placebo-controlled trial of bronchodilators for bronchoscopy in patients with COPD.
- Stolz D The Clinic of Respiratory Medicine and Pulmonary Cell Research University Hospital Basel, Basel, Switzerland. Electronic address: stolzd@ummhc.org.
- Pollak V The Clinic of Respiratory Medicine and Pulmonary Cell Research University Hospital Basel, Basel, Switzerland.
- Chhajed PN The Clinic of Respiratory Medicine and Pulmonary Cell Research University Hospital Basel, Basel, Switzerland.
- Gysin C The Clinic of Respiratory Medicine and Pulmonary Cell Research University Hospital Basel, Basel, Switzerland.
- Pflimlin E The Clinic of Respiratory Medicine and Pulmonary Cell Research University Hospital Basel, Basel, Switzerland.
- Tamm M The Clinic of Respiratory Medicine and Pulmonary Cell Research University Hospital Basel, Basel, Switzerland.
- 2007-03-16
Published in:
- Chest. - 2007
Administration, Inhalation
Adult
Aged
Aged, 80 and over
Albuterol
Bronchodilator Agents
Bronchoscopy
Double-Blind Method
Female
Forced Expiratory Volume
Humans
Male
Middle Aged
Premedication
Pulmonary Disease, Chronic Obstructive
Statistics as Topic
Vital Capacity
English
BACKGROUND
In contrast to asthma, the indication for bronchodilators prior to bronchoscopy in patients with COPD has not been properly investigated. We therefore performed a randomized, double-blind, placebo-controlled trial to determine whether use of a short-acting bronchodilator provides a protective effect in patients with COPD undergoing bronchoscopy.
METHODS
One hundred twenty patients undergoing bronchoscopy were included. Patients with COPD were randomized to receive either 200 mug of salbutamol (n = 40) or placebo (n = 40) before bronchoscopy. Control patients (n = 40) did not receive any inhaled medication. Spirometry was performed before and 2 h after bronchoscopy in all patients. Sedative drug requirements and hemodynamic parameters were recorded.
RESULTS
Hemodynamic findings before, during, and after bronchoscopy were similar in patients with COPD randomized to either salbutamol or placebo (p = not significant for all). Compared to prebronchoscopy values, postbronchoscopy percentage of predicted FEV(1) decreased significantly in all three groups: salbutamol (median, - 4.7%; interquartile range [IQR], - 13.3 to 6.6); placebo (median, - 4.8%; IQR, - 19.9 to 8.4); and control subjects (median, - 10.0%; IQR, - 20.2 to - 3.3) [p = 0.023]. The decrease in FEV(1) was similar in all three patient groups (p = 0.432). The relative change in FEV(1) was inversely correlated to the increasing severity of COPD as expressed by Global Initiative for Chronic Obstructive Lung Disease stages (p = 0.01).
CONCLUSIONS
Premedication with an inhaled short-acting beta-agonist cannot be recommended in patients with COPD undergoing bronchoscopy.
In contrast to asthma, the indication for bronchodilators prior to bronchoscopy in patients with COPD has not been properly investigated. We therefore performed a randomized, double-blind, placebo-controlled trial to determine whether use of a short-acting bronchodilator provides a protective effect in patients with COPD undergoing bronchoscopy.
METHODS
One hundred twenty patients undergoing bronchoscopy were included. Patients with COPD were randomized to receive either 200 mug of salbutamol (n = 40) or placebo (n = 40) before bronchoscopy. Control patients (n = 40) did not receive any inhaled medication. Spirometry was performed before and 2 h after bronchoscopy in all patients. Sedative drug requirements and hemodynamic parameters were recorded.
RESULTS
Hemodynamic findings before, during, and after bronchoscopy were similar in patients with COPD randomized to either salbutamol or placebo (p = not significant for all). Compared to prebronchoscopy values, postbronchoscopy percentage of predicted FEV(1) decreased significantly in all three groups: salbutamol (median, - 4.7%; interquartile range [IQR], - 13.3 to 6.6); placebo (median, - 4.8%; IQR, - 19.9 to 8.4); and control subjects (median, - 10.0%; IQR, - 20.2 to - 3.3) [p = 0.023]. The decrease in FEV(1) was similar in all three patient groups (p = 0.432). The relative change in FEV(1) was inversely correlated to the increasing severity of COPD as expressed by Global Initiative for Chronic Obstructive Lung Disease stages (p = 0.01).
CONCLUSIONS
Premedication with an inhaled short-acting beta-agonist cannot be recommended in patients with COPD undergoing bronchoscopy.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1378/chest.06-2308
- PMID 17356091
- Persistent URL
- https://folia.unifr.ch/global/documents/205130
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