OBJECTIVETo investigate the therapeutic efficacy and safety of salbutamol and dexamethasone added into large-volume whole lung lavage (WLL) fluid in patients with pneumoconiosis.

METHODSA total of 176 patients with pneumoconiosis were randomly divided into control group (n=86) and treatment group (n=90). The control group received WLL with 0.9% sodium chloride solution, while for the treatment group, salbutamol and dexamethasone were added into the WLL fluid for both lungs at the 1st and 4th WLLs.Before and after WLL, the pulmonary wheezing, arterial partial pressure of oxygen (Pa02), peak airway pressure(Pa peak), amount of intrapulmonary residual fluid, forced expiratory volume in one second (FEVw) (72 h later),diffusion capacity for carbon monoxide (DLCO ), and forced vital capacity (FVC) were measured for comparison between the two groups.

RESULTSAfter WLL, the treatment group had a significantly lower detection rate of pulmonary wheezing than the control group ( 13.3% vs 29.1 %, x2=5.028, ?=0.025), and the control group had a significantly higher incidence rate of pulmonary wheezing than the treatment group (21.8% vs 3.7%, 0R=5.423,95%CI 2.036-9.568 ). Compared with the control group, the treatment group had significantly higher Pa02 and significantly lower Pa peak and amount of intrapulmonary residual fluid (t =2.163 -4.132, P<0.05) and significantly higher FEV1, DLCO, and FVC (t=1.986-2.345, P<0.05) after WLL.

CONCLUSIONSalbutamol and dexamethasone added into large-volume WLL fluid may effectively alleviate bronchial spasm, reduce hypoxemia, and decrease Pa peak in patients with pneumoconiosis, thus promoting lung function recovery after WLL.

Adult ; Albuterol ; administration & dosage ; Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; Dexamethasone ; administration & dosage ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy ; Young Adult

PURPOSE: To determine if intravenous aminophylline adds any efficacy to nebulized albuterol and intravenously administered corticosteroid in children who hospitalized with mild to moderate asthma. METHOD: Subjects were children between the ages of 5 and 15 years admitted of acute asthma attack to Department of Pediatrics, Kyung Hee University Hospital. All patient received therapy with albuterol delivered with nebulization at 4-6 hour interval and intravenously adminstered methylprednisolone in standardized doses. Thirty patients were recruited to receive either an intravenous aminophylline(n=15) or not(n=15). The outcome variables were:duration of hospitalization, percent of predicted peak expiratory flow rates recorded at 12-hour intervals and side effects. When intravenously administered medications were discontinued, therapy continued with oral administration of theophylline. Twice daily assessments of clinical asthma symptoms were made by using a scoring system consisting of respiratory rate, wheeze and accessory muscle use. RESULTS: 1) There were no significant differences at study entry in age, sex, race, number of previous hospital admission, clinical symptom scores, or initial peak flow rates for the two groups. 2) Fifteen patients in the aminophylline group were hospitalized for an mean duration of 5.1+/-1.0 days, whereas 15 patients in the control group required 5.3+/-1.2 days. There were no significant differences between the two groups. 3) There was no differences in the absolute changes in their scores two scoring intervals(at 24 hours) between the two groups. 4) The two groups showed no differences in measurements of peak expiratory flow rates at any time interval and at the end of treatment. 5) The mean theophylline level for aminophylline group was 10.2+/-1.7micorgram/mL. 6) In the aminophylline group, 6 of 15 patients who entered the study experienced adverse effects consisting of nausea/vomiting, abdominal pain, and irritability. Five of 15 patients in the control group had an adverse effects. There were no significant differences between the two groups for incidence of adverse effects. 7) There were no significant differences between the two groups for amount of albuterol therapy required. CONCLUSION: When the combination of systemically administered corticosteroid and inhaled albuterol is used in hospitalized asthmatic children with mild to moderate asthma, addition of theophylline provided no additional benefit. Further study will be needed to evaluate if patients with more severe asthma exacerbation benefit for the use of intraveously administered aminophylline.
Abdominal Pain ; Administration, Oral ; Albuterol ; Aminophylline* ; Asthma* ; Child ; Continental Population Groups ; Hospitalization ; Humans ; Incidence ; Methylprednisolone ; Pediatrics ; Respiratory Rate ; Theophylline

OBJECTIVETo assess the efficacy of two vehicles for nebulized salbutamol in treatment of asthma exacerbations with Meta-analysis.

METHODSAll relevant randomized controlled clinical trials (RCT) with isotonic magnesium sulphate and saline as vehicles for inhaled salbutamol in treatment of asthma exacerbations were searched. A Meta-analysis was performed to evaluate the results of the two therapies.

RESULTFive relevant RCTs from literature were collected and total 219 cases were included for analysis. The meta-analysis indicated that the significant improvements were obtained from isotonic magnesium sulphate as a vehicle for nebulized salbutamol, in comparison with saline [pooled standardized mean difference (SMD)=0.55(95% CI 0.28 - 0.83), P <0.001]. By further subgroup analysis, this change was properly significant in the subgroup of severe patients with their baseline FEV1% <30% [FEV1 weighted mean difference (WMD)=0.72 L(95% CI 0.30 L - 1.14 L), P <0.01]. The pooled results of vital signs between two vehicles did not demonstrate statistical significance. Overall, the risk of admission to hospital was not statistically reduced in patients using magnesium sulphate, who presented to the emergency department with an asthma exacerbation [pooled RR=0.64(95% CI 0.38 - 1.08), P >0.05].

CONCLUSIONCompared with saline,the use of isotonic magnesium sulfate as an adjuvant to nebulize salbutamol is a beneficial therapy with improving spirometric airway function in the severe asthma exacerbation.

Adrenergic beta-Agonists ; administration & dosage ; Albuterol ; administration & dosage ; Asthma ; drug therapy ; Female ; Humans ; Magnesium Sulfate ; administration & dosage ; Male ; Nebulizers and Vaporizers ; Pharmaceutical Vehicles ; Randomized Controlled Trials as Topic

We report here on the redistributed regional ventilation abnormalities after the administration of a bronchodilator and as seen on xenon-inhaled dual-energy CT in a patient with asthma. The improved ventilation seen in the right lower lobe and the decreased ventilation seen in the right middle lobe after the administration of a bronchodilator on xenon-inhaled dual-energy CT could explain a positive bronchodilator response on a pulmonary function test. These changes may reflect the heterogeneity of the airway responsiveness to a bronchodilator in patients with asthma.
Albuterol/*administration & dosage ; Asthma/*physiopathology/*radiography ; Bronchodilator Agents/*administration & dosage ; Child ; Female ; Humans ; Pulmonary Ventilation ; Radiation Dosage ; Tomography, X-Ray Computed/*methods ; Xenon/diagnostic use

This paper is to study the iso-butane (A-31)-driven salbutamol sulfate (SS) metered dose inhaler (MDI) formulations and inhaling status in guinea pigs. Solubility determination and orthogonal design were used to screen non-chlorofluorocarbon (CFC) SS MDI formulations. Intubation inhalation of MDI in guinea pigs was used as a main administration method. Fluorescence HPLC detection method was testified as a potential method in assaying the concentration of SS in plasma of guinea pigs after inhaling various SS MDI formulations. Analysis of the data was executed with statistical moment calculation from which pharmacokinetic parameters were obtained. The results show that A-31 based on SS MDI formulations were screened and the guinea pigs in vivo determination method after inhaling SS MDI was established. The zero-moment rations of SS/A-31 MDI formulation to contrast sample and CFC SS MDI was 143.26% and 147.01%, respectively. The first moment value of SS/A-31 MDI formulation was the highest. It is a preliminary conclusion that the absorption result of SS/A-31 MDI formulation inhaled by guinea pigs is equivalent to HFA-134a formulation in sale and better than CFC formulation. A-31 could be used as a potential substitute candidate for CFC MDI propellant.
Administration, Inhalation ; Aerosol Propellants ; Albuterol ; administration & dosage ; pharmacokinetics ; Animals ; Butanes ; adverse effects ; pharmacokinetics ; Female ; Guinea Pigs ; Male ; Metered Dose Inhalers ; Respiratory System ; metabolism

BACKGROUNDAcute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common condition, which affects not only the quality of life of patients but also their prognosis. The purpose of this study was to explore the effects of an inhaled salbutamol sulfate solution and an inhalation suspension of the glucocorticoid budesonide that were atomized with heliox to treat patients with AECOPD.

METHODSTwenty-three patients with AECOPD were divided into a treatment group (He/O2 = 70%/30%) and a control group (N2/O2 = 70%/30%). The salbutamol sulfate and budesonide were administered by inhalation twice a day for 7 days. Vital signs, arterial blood gas levels, pulmonary function and the levels of serum myostatin (sMSTN) were measured and lung vibration imaging was performed.

RESULTSWe found that the PaO2 and PaCO2 values were not significantly different between the two groups at the various time points (P > 0.05). There were also no significant differences in any of the parameters of pulmonary function between the two groups. However, after baseline correction, the increase rate of the forced expiratory volume in one second (FEV1), the forced vital capacity (FVC), and the maximum minute ventilation (MVV) appeared to be significantly increased at some time points compared with the baseline (before treatment) in both groups (P < 0.05). Although the values of quantitative lung distribution (QLD) for different regions and the levels of sMSTN were slightly different between the two groups, the repeated measures analysis of variance (ANOVA) revealed that there were no significant differences between the two groups or within any group (P > 0.05).

CONCLUSIONAlthough the use of heliox as a driving gas can improve symptoms and benefit patients with AECOPD, the heliox treatment group did not have significant differences in arterial blood gases, lung function, lung vibration response imaging or the levels of sMSTN compared with the control group. (Chinese Clinical Trial Register Center ChiCTRTRC-00000273).

Administration, Inhalation ; Aged ; Albuterol ; administration & dosage ; therapeutic use ; Budesonide ; administration & dosage ; therapeutic use ; Drug Interactions ; Female ; Helium ; administration & dosage ; therapeutic use ; Humans ; Male ; Middle Aged ; Oxygen ; administration & dosage ; therapeutic use ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; drug therapy

OBJECTIVEThe efficacy of bronchodilator in asthmatoid bronchitis remains controversial. This study was designed to investigate the effects of bronchodilators, salbutamo and ipraopium bromide, on the pulmonary function in young children with this disease.

METHODSPulmonary function tests were performed in 20 children with asthmatoid bronchitis (2 months-2.5 years of age) before and 30, 60, and 120 minutes after salbutamo and ipratropium bromide inhalation. The indexes of pulmonary function measured included tidal breathing flow volume (TBFV) loop, percent of tidal volume to peak tidal expiratory flow (%V-PF), terminal flows per peak expiratory flow (25/PF), peak tidal expiratory flow (PTEF), rate of mid-expiratory to mid-inspiratory flow (ME/MI), respiratory rate (RR) and tidal volume per kilogram (TV/kg).

RESULTSBefore drug inhalation, the descending branch of the TBFV loop was depressed. The PTEF shifted forward and %V-PF (0.19 +/- 0.04) and 25/PF (0.42 +/- 0.11) decreased. These changes did not improve and the remaining indexes, RR, ME/MI and TV/kg, 30, 60, and 120 minutes after drug inhalation also remained similar to before inhalation.

CONCLUSIONSSalbutamo and ipratropium bromide inhalation did not improve the airway resistance and ventilation function in children with asthmatoid bronchitis. This suggests that the efficacy of bronchodilator in the treatment of this disease is doubtful.

Administration, Inhalation ; Albuterol ; administration & dosage ; Asthma ; drug therapy ; physiopathology ; Bronchitis ; drug therapy ; physiopathology ; Bronchodilator Agents ; administration & dosage ; Child, Preschool ; Female ; Humans ; Infant ; Ipratropium ; administration & dosage ; Lung ; drug effects ; physiopathology ; Male

OBJECTIVETo evaluate the efficacy of 3 commonly used protocols for management of acute exacerbation of asthma in children.

METHODSTotally 113 asthmatic children were randomized into 3 groups. In group A (53 cases), the children were treated with inhalation of nebulized budesonide suspension plus salbutamol and ipratropium bromide twice daily for 5 days; in group B (41 cases), budesonide plus salbutamol and ipratropium aerosol was administered, and in group C (29 cases), dexathmisone plus aminophylline injection was given once daily for 5 days. All the children received basic treatment with fluid infusion, antibiotics or/and anti-virus medications.

RESULTSThe children in both groups A and C showed effectively controlled asthma attack, with significant differences in the therapeutic effects (P>0.05). In contrast, only a few children showed improvement in group B, suggesting the ineffectiveness of the treatment.

CONCLUSIONNebulized medicine is one of the best means for management of acute asthma exacerbation in children, and inhalation of budesonide suspension plus salbutamol and ipratropium bromide can effectively relieve the asthmatic symptoms in these children with good compliance and convenient administration.

Acute Disease ; Adolescent ; Aerosols ; Albuterol ; administration & dosage ; therapeutic use ; Asthma ; drug therapy ; Bronchodilator Agents ; administration & dosage ; therapeutic use ; Budesonide ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Drug Therapy, Combination ; Female ; Humans ; Infant ; Ipratropium ; administration & dosage ; therapeutic use ; Male ; Treatment Outcome

OBJECTIVETo investigate the effects of inhaled short-acting bronchodilators on diaphragm function and neural respiratory drive in patients with chronic obstructive pulmonary disease (COPD) during maximal isocapnic ventilation (MIV).

METHODSForty-seven patient with moderate to severe COPD were randomized into 4 groups: placebo group (n=12), salbutamol group (n=13), ipratropium group (n=10), and combined group (salbutamol and ipratropium, n=12). Each subject received an initial MIV for 3 min at baseline and inhaled placebo (400 µg), salbutamol (400 µg), ipratropium (80 µg), or both salbutamol and ipratropium, followed 30 min later by another 3 min of MIV. The parameters of diaphragm function and neural respiratory drive were monitored continuously and calculated during MIV.

RESULTSDuring the initial MIV, all the patients experienced a linear increase in root mean square (RMS) of diaphragm electromyogram with a gradual decrease in transdiaphragmatic pressure (Pdi), minute ventilation (VE), and VE/RMS, and these parameters all improved significantly after inhalation of the bronchodilators. Compared with the placebo group at the same time point, the 3 bronchodilator-treated groups showed significantly decreased RMS and Borg score and increased Pdi, VE and VE/RMS; VE/RMS was the highest in the combined treatment group (P<0.05). The Delta Borg was significantly correlated with Delta Pdi, Delta VE, Delta RMS, and Delta VE/RMS (P<0.05).

CONCLUSIONSIn COPD patients, inhaled short-acting bronchodilators can alleviate diaphragm fatigue during MIV, increase lung ventilation, reduce neural respiratory drive, and improve neuro-ventilatory coupling to relieve dyspnoea, and the combination of β-2 agonists and anti-muscarinic antagonists produces a stronger efficacy.

Administration, Inhalation ; Albuterol ; therapeutic use ; Bronchodilator Agents ; therapeutic use ; Diaphragm ; drug effects ; Humans ; Ipratropium ; therapeutic use ; Pulmonary Disease, Chronic Obstructive ; drug therapy ; Respiration

OBJECTIVETo observe changes in the lung function of asthmatic children with different symptoms during treatment, and to investigate the clinical significance of bronchial reversibility test in the treatment of asthma in children.

METHODSA total of 417 asthmatic children were treated by salmeterol/fluticasone inhalation for more than 3 months. These patients were divided into asymptomatic, single cough, paroxysmal cough and wheeze (cough+wheeze or wheeze alone) groups based on the symptoms when they revisited the clinic. Thirty-four healthy children were used as a control group. All children underwent bronchial reversibility test using nebulized salbutamol. Lung function testing was performed before and after the test.

RESULTSAfter nebulization of salbutamol, each asthma group showed significantly decreased rate of abnormal lung function and significantly increased forced expiratory volume in one second percent (FEV1%) predicted (P<0.05). Before salbutamol nebulization, the single cough, paroxysmal cough and wheeze groups had significantly higher rates of abnormal lung function and significantly lower FEV1% predicted than the control group (P<0.05). There were significant differences in the rate of abnormal lung function and FEV1% predicted among the asthma groups (P<0.05). After salbutamol nebulization, the paroxysmal cough and wheeze groups had significantly higher rates of abnormal lung function than the control group (P<0.05), but there were no significant differences between other asthma and control groups; the wheeze group had significantly lower FEV1% predicted than the control group, but no significant differences were found between other asthma and the control groups. The positive rate of bronchial reversibility test in each asthma group was significantly higher than in the control group (P<0.05). There were significant differences in the positive rate of the test between the asthma groups except between the asymptomatic and single cough groups (P<0.05).

CONCLUSIONSAsthmatic children with different symptoms demonstrate different lung functions during treatment. Bronchial reversibility test combined with lung function test is useful in assessing asthma control and guiding treatment.

Administration, Inhalation ; Adolescent ; Albuterol ; administration & dosage ; adverse effects ; analogs & derivatives ; Androstadienes ; administration & dosage ; adverse effects ; Asthma ; drug therapy ; physiopathology ; Bronchi ; physiopathology ; Child ; Drug Combinations ; Female ; Fluticasone-Salmeterol Drug Combination ; Forced Expiratory Volume ; Humans ; Lung ; physiopathology ; Male