Salmeterol improves fluid clearance from alveolar-capillary membrane in COPD patients: a pilot study.

Publisher: Academic Press Country of Publication: England NLM ID: 9715279 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1522-9629 (Electronic) Linking ISSN: 10945539 NLM ISO Abbreviation: Pulm Pharmacol Ther Subsets: MEDLINE

Publication: London : Academic Press
Original Publication: London ; New York : Academic Press, c1997-

Albuterol/*analogs & derivatives ; Bronchodilator Agents/*therapeutic use ; Capillaries/*physiopathology ; Pulmonary Alveoli/*physiopathology ; Pulmonary Disease, Chronic Obstructive/*drug therapy; Adult ; Aged ; Aged, 80 and over ; Albuterol/therapeutic use ; Body Fluids/metabolism ; Capillaries/metabolism ; Carbon Monoxide/metabolism ; Double-Blind Method ; Female ; Humans ; Male ; Membranes/drug effects ; Membranes/physiology ; Middle Aged ; Pilot Projects ; Pulmonary Alveoli/metabolism ; Pulmonary Diffusing Capacity/drug effects ; Pulmonary Disease, Chronic Obstructive/physiopathology ; Pulmonary Gas Exchange ; Respiratory Function Tests ; Respiratory Mechanics/drug effects ; Salmeterol Xinafoate

Unlabelled: The cardiovascular component associated with chronic obstructive pulmonary disease (COPD) plays a major role in disease prognosis, accounting for 25% of the deaths. Experimental and initial clinical data suggest that beta-adrenergic agonists accelerate fluid clearance from the alveolar airspace, with potentially positive effects on cardiogenic and noncardiogenic pulmonary oedema. This pilot study investigated the acute effects of the long-acting beta-2 agonist, salmeterol, on alveolar fluid clearance after rapid saline intravenous infusion by evaluating diffusive and mechanical lung properties. Ten COPD and 10 healthy subjects were treated with salmeterol or placebo 4 h before the patient's mechanical and diffusive lung properties were measured during four non consecutive days, just before and after a rapid saline infusion, or during a similar period without an infusion.
Results: In both COPD and healthy subjects, rapid saline infusion with placebo or salmeterol premedication lead to a significant decrease in diffusion capacity for carbon monoxide (DLCO) and forced expiratory volume in 1 s (FEV1). Nonetheless, salmeterol pretreatment lead to a significantly reduced gas exchange impairment caused by saline infusion (-64% of DLCO reduction compared with placebo), whereas it did not affect changes in FEV1. In the control setting with no infusion, we found no significant change in either DLCO or mechanical properties of the lung.
Conclusions: Salmeterol appears to provide a protective effect, not related to bronchodilation, against an acute alveolar fluid clearance challenge secondary to lung fluid overload in COPD patients.
(Copyright © 2012 Elsevier Ltd. All rights reserved.)

0 (Bronchodilator Agents)
6EW8Q962A5 (Salmeterol Xinafoate)
7U1EE4V452 (Carbon Monoxide)
QF8SVZ843E (Albuterol)

Date Created: 20120117 Date Completed: 20120410 Latest Revision: 20151119

20240829

10.1016/j.pupt.2011.12.010

22245487