Effect of different albuterol dosing regimens in the treatment of acute exacerbation of chronic obstructive pulmonary disease.

Study Objective: To compare hourly administration of albuterol with more frequent administration of a higher cumulative dose in patients with an acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods: Participants in this pilot study were patients older than 50 years who presente...

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Publicado en:Annals of Emergency Medicine Vol. 29; no. 4; pp. 474 - 479
Autores principales: Emerman CL, Cydulka RK, Emerman, C L, Cydulka, R K
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. 1997 Apr
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 1997 Apr
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        atl: Effect of different albuterol dosing regimens in the treatment of acute exacerbation of chronic obstructive pulmonary disease.
      aug:
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          Emerman CL
          Cydulka RK
          Emerman, C L
          Cydulka, R K
        affil: Department of Emergency Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA
      sug:
        subj:
          Pulmonary Disease, Chronic Obstructive Drug Therapy
          Albuterol Administration and Dosage
          Pilot Studies
          Emergency Service
          Forced Expiratory Volume
          Time Factors
          Albuterol Adverse Effects
          Nebulizers and Vaporizers
          Record Review
          Pretest-Posttest Control Group Design
          T-Tests
          Chi Square Test
          Data Analysis Software
          Confidence Intervals
          Analysis of Variance
          Repeated Measures
          Aged
          Male
          Female
          Human
          Aged: 65+ years
          Male
          Female
      ab: Study Objective: To compare hourly administration of albuterol with more frequent administration of a higher cumulative dose in patients with an acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods: Participants in this pilot study were patients older than 50 years who presented to the emergency department with an acute exacerbation of COPD. After initial assessment and spirometry, all patients received nebulized aerosols every 20 minutes. Patients were randomly assigned to receive either albuterol (2.5 mg) every 60 minutes for two doses, interspersed with saline aerosols every 20 minutes; or albuterol (2.5 mg) every 20 minutes for 2 hours. Patients were assessed with spirometry after 60 and 120 minutes. No other medications were administered during the course of this study.Results: Eighty-six patients were enrolled in the study. No statistically significant difference was found between groups in mean 1-second forced expiratory volume (FEV1) at study initiation, 1 hour, or 2 hours or in the interval changes in mean FEV1. There was, however, almost twice as much improvement in FEV1 in the higher-dose group. Group hospitalization rates were similar. There were more side effects in the higher-dose group (45% versus 24%, P < .05). Among 32 patients with a pretreatment FEV1 less than 20% of predicted, there was a significantly greater interval improvement in FEV1 at both 1 hour and 2 hours.Conclusion: This study failed to demonstrate a statistically significant advantage to use of a higher cumulative dose of albuterol in patients with acute exacerbation of COPD, possibly because of type II statistical error. There may be an advantage to more frequent dosing, particularly in patients with initially severe bronchospasm, although at the expense of more frequent side effects.
      pubtype: Academic Journal
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        tables/charts
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      ougenre: Article
    language: English
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