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• W2005455250 abstract "Rationale: Short-acting β2-agonists are one of the mainstays of bronchodilator strategy for exacerbations of chronic obstructive pulmonary disease (COPD). The assessment of pulmonary gas exchange after salbutamol in COPD severe exacerbations remains unknown.Objectives: We investigated whether the effects of nebulized salbutamol during COPD severe exacerbations are associated with further deterioration of pulmonary gas exchange.Methods: We examined patients with severe COPD when hospitalized for exacerbation (n = 9), and while in stable convalescence.Measurements and Main Results: We assessed spirometry, arterial blood gases, systemic hemodynamics, and V̇/Q̇ relationships 30 and 90 minutes after administration of 5.0 mg salbutamol. At exacerbation, compared with baseline, 30 minutes after salbutamol administration, cardiac output (Q̇) increased (from 6.5 ± [SEM] 0.4 to 7.3 ± 0.5 L · min−1) (p < 0.03) alone, without inducing changes in gas exchange indices. When in convalescence, compared with baseline, 30 minutes after salbutamol, there was an increase in Q̇ (from 5.7 ± 0.5 to 7.0 ± 0.6 L · min−1) and V̇o2 (from 211 ± 12 to 232 ± 11 ml · min−1) (p < 0.002 each), whereas PaO2 decreased (from 71 ± 4 to 63 ± 3 mm Hg) and alveolar–arterial Po2 difference increased due to increased perfusion of low–V̇/Q̇-ratio regions (from 4.5 ± 2.6 to 9.6 ± 4.1% of Q̇) (p < 0.05); SaO2 (93 ± 2%) and PaCO2 (43 ± 2 mm Hg) remained unchanged. This deleterious gas exchange response persisted at 90 minutes.Conclusions: At exacerbation, salbutamol does not aggravate pulmonary gas exchange abnormalities. When in convalescence, however, baseline lung function improvement was associated with a detrimental gas exchange response to salbutamol, resulting in further V̇/Q̇ imbalance and small decreases in PaO2 compounded by small increases in Q̇ and V̇o2." @default.
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• W2005455250 date "2007-08-15" @default.
• W2005455250 modified "2023-09-27" @default.
• W2005455250 title "Gas Exchange Response to Short-Acting β₂-Agonists in Chronic Obstructive Pulmonary Disease Severe Exacerbations" @default.
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• W2005455250 doi "https://doi.org/10.1164/rccm.200612-1864oc" @default.
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