Source: Annual Congress 2002 - Lung mechanics: from laboratory to bedside
Disease area: Airway diseases

Abstract

Bronchodilators lead to symptomatic improvement in patients with COPD that are not always explained by improvements in forced expiratory flows. We hypothesized that decreases in hyperinflation might account for this discrepancy. Therefore in a placebo-controlled trial conducted on 9 patients with stable COPD (FEV1=47.1±] 6.3SE % predicted) we measured the influence of nebulised salbutamol on total lung capacity (TLC), functional residual capacity (FRC), residual volume (RV) and vital capacity (VC) by opto-electronic plethysmography (OEP) (Cala et al., JAP, 1996). Placebo and salbutamol were administered in separate days. Absolute volumes of chest wall (Vcw), abdomen (Vab) and rib cage (Vrc) were measured during forced VC maneuvers before and 45 minutes after 5 mg salbutamol (S) and placebo (P). We conclude that bronchodilators decrease hyperinflation by decreasing Vab, gas trapping by decreasing Vab and Vrc. They increase VC in the rib cage compartment. This may explain some of the symptomatic improvement.

	Δ Vcw(ml)	Δ Vcw(ml)	Δ Vab (ml)	Δ Vab (ml)	Δ Vrc(ml)	ΔVrc(ml)
	P	S	P	S	P	S
TLC	-145 (n.s.)	-201 (*)	-65 (n.s.)	-162 (*)	-79 (n.s.)	-39 (n.s.)
FRC	-171 (n.s.)	-433 (***)	-9 (n.s.)	-411 (***)	-161 (n.s.)	-22 (n.s.)
RV	+63 (n.s.)	-561 (***)	+101 (n.s.)	-280 (*)	-37 (n.s.)	-280 (***)
VC	-208 (*)	+360 (**)	-167 (n.s.)	+118 (n.s.)	-42 (n.s.)	+241 (***)

(*=p<0.05, **=p<0.01, ***=p<0.001; Δ =change between pre and post intervention).

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Citations should be made in the following way:
A. Aliverti, R. Dellacà, N. Stevenson, A. Pedotti, A. Lo Mauro, P. M. A. Calverley (Milan, Italy; Liverpool, United Kingdom). Effects of bronchodilators on subdivisions of lung and chest wall volume in COPD. Eur Respir J 2002; 20: Suppl. 38, 190

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