Modulation of operational lung volumes with the use of salbutamol in COPD patients accomplishing upper limbs exercise tests

• Autor(a) principal: Porto, Elias Ferreira [UNIFESP]
• Data de Publicação: 2009
• Outros Autores: Castro, Antônio Adolfo Mattos de [UNIFESP], Nascimento, Oliver Augusto [UNIFESP], Oliveira, Rosangela C. [UNIFESP], Cardoso, Fábio [UNIFESP], Jardim, José Roberto [UNIFESP]
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1016/j.rmed.2008.08.018; http://repositorio.unifesp.br/handle/11600/31264
• topic: Upper limbs exercise; Dynamic hyperinflation; Salbutamol; COPD

Introduction: Pulmonary dynamic hyperinflation (DH) is an important factor limiting the physical capacity of patients with COPD. Inhaled bronchodilator should be able to reduce DH.Objective: To measure DH in COPD patients during upper limbs exercise tests with previous use of bronchodilator or placebo, and to evaluate the respiratory pattern to justify the dynamics of hyperinflation.Methods: Inspiratory capacity (IC) of 16 patients with COPD (age: 63 13 years; FEV(1) of 1.5 +/- 0.7 L-41 +/- 11% predicted) was measured before and after an incremental arm exercise test (diagonal technique) with randomly and double-blinded inhaled placebo or salbutamol. Results: Rest IC increased from 2.32 +/- 0.44 L to 2.54 +/- 0.39 L after inhalation of 400 mcg of salbutamol. (p = 0.0012). There was a decrease in the IC after a maximal incremental arm exercise test, 222 +/- 158 ml. (p = 0.001) with placebo use, but no change was seen after the salbutamol use: 104 +/- 205 ml (p = 0.41); 62% of the patients presented a 10% or more reduction in the IC after the exercise with placebo. There was a correlation between DH and lower FEV(1)/FVC (p = 0.0067), FEV, predicted (p = 0.0091) and IC% predicted (p = 0.043) and higher VO(2) ml/Kg/min % predicted (p = 0.05). Minute ventilation and respiratory rate were higher during the exercise with placebo (p = 0.002) whereas VE/MVV ratio was tower in the exercise after salbutamol (p > 0.05).Conclusion: We conclude that the use of bronchodilator increases the IC of patient with COPD and may help not to increase the DH during a maximal. exercise with the arms. (C) 2008 Elsevier B.V. All rights reserved.