International Journal of COPD (Jan 2016)
Effect of salmeterol/fluticasone combination on the dynamic changes of lung mechanics in mechanically ventilated COPD patients: a prospective pilot study
Abstract
Wei-Chih Chen,1,2 Hung-Hsing Chen,2 Chi-Huei Chiang,2 Yu-Chin Lee,3 Kuang-Yao Yang1,2 1Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 2Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; 3Sijhih Cathay General Hospital, Taipei, Taiwan Background: The combined therapy of inhaled corticosteroids and long-acting beta-2 agonists for mechanically ventilated patients with COPD has never been explored. Therefore, the aim of this study was to investigate their dynamic effects on lung mechanics and gas exchange. Materials and methods: Ten mechanically ventilated patients with resolution of the causes of acute exacerbations of COPD were included. Four puffs of salmeterol 25 µg/fluticasone 125 µg combination therapy were administered. Lung mechanics, including maximum resistance of the respiratory system (Rrs), end-inspiratory static compliance, peak inspiratory pressure (PIP), plateau pressure, and mean airway pressure along with gas exchange function were measured and analyzed. Results: Salmeterol/fluticasone produced a significant improvement in Rrs and PIP after 30 minutes. With regard to changes in baseline values, salmeterol/fluticasone inhalation had a greater effect on PIP than Rrs. However, the therapeutic effects seemed to lose significance after 3 hours of inhaled corticosteroid/long-acting beta-2 agonist administration. Conclusion: The combination of salmeterol/fluticasone-inhaled therapy in mechanically ventilated patients with COPD had a significant benefit in reducing Rrs and PIP. Keywords: COPD, inhaled corticosteroid, long-acting beta-2 agonist, mechanical ventilation, respiratory failure
