Respiratory medicine
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Respiratory medicine · Mar 2011
Randomized Controlled Trial Multicenter StudyMK-0633, a potent 5-lipoxygenase inhibitor, in chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD) is associated with neutrophil-mediated inflammation, a potential target for treatment in COPD. We evaluated MK-0633, a 5-lipoxygenase inhibitor in patients with COPD. This was a 12 week, randomized, double-blind, multicenter study comparing MK-0633 100 mg and placebo in patients 40-75 years of age (N = 266) with COPD, post-β-agonist forced expiratory volume in 1 s (FEV(1)) 25%-75% predicted, and an FEV(1)/forced vital capacity ratio (FVC) ≤ 70%. ⋯ MK-0633 was well-tolerated and comparable to placebo. The 5-LO inhibitor MK-0633 was not significantly more effective than placebo in improving FEV(1) from baseline in patients with COPD, although more patients reported feeling improved with MK-0633. Clinicaltrials.gov identifier: NCT00418613.
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Respiratory medicine · Mar 2011
Randomized Controlled TrialLong-term non-invasive ventilation in COPD after acute-on-chronic respiratory failure.
COPD patients who remain hypercapnic after acute respiratory failure requiring mechanical ventilation have a poor prognosis. Long-term nocturnal non-invasive ventilation (NIV) may be beneficial for these patients. We hypothesized that stable patients on long-term NIV would experience clinical worsening after withdrawal of NIV. ⋯ COPD patients who remain hypercapnic after acute respiratory failure requiring mechanical ventilation may benefit from long-term NIV.
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Respiratory medicine · Mar 2011
Randomized Controlled TrialContrasting pressure-support ventilation and helium-oxygen during exercise in severe COPD.
Helium-oxygen mixtures and pressure-support ventilation have been used to unload the respiratory muscles and increase exercise tolerance in COPD. Considering the different characteristics of these techniques, we hypothesized that helium-oxygen would be more effective in reducing exercise-induced dynamic hyperinflation than pressure-support. We also hypothesized that patients would experience greater increases in respiratory rate and minute ventilation with helium-oxygen than with pressure-support. ⋯ In conclusion, helium-oxygen reduced exercise-induced dynamic hyperinflation by improving the relationship between hyperinflation and minute ventilation. In contrast, pressure-support reduced hyperinflation solely as a result of lowering ventilation. Helium-oxygen was more effective in reducing exercise-induced dynamic hyperinflation in severe COPD, and was associated with greater increases in respiratory rate and minute ventilation than pressure-support.
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Respiratory medicine · Mar 2011
Outcome measurement for COPD: reliability and validity of the Dyspnea Management Questionnaire.
The Dyspnea Management Questionnaire (DMQ) is a measure of the psychosocial and behavioral responses to dyspnea for adults with COPD. The research objectives were to evaluate the reliability and validity of an expanded DMQ item pool, as a preliminary step for developing a computer adaptive test. ⋯ The DMQ demonstrated acceptable levels of reliability and validity for measuring multidimensional dyspnea outcomes after medical, psychological, and behavioral interventions for adults with COPD.
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Respiratory medicine · Mar 2011
Potentially modifiable predictors of mortality in patients treated with long-term oxygen therapy.
Anemia is considered a systemic manifestation of Chronic Obstructive Pulmonary Disease (COPD); however, few studies have described its influence on chronic respiratory failure (CRF) prognosis. We aimed to test the hypotheses that anemia negatively influences survival and also to identify the cut-off points of hematocrit (Htc) and hemoglobin (Hb) associated with higher mortality in CRF patients using long-term oxygen therapy (LTOT). ⋯ Our study shows that anemia is a predictor of mortality in patients with CRF under LTOT treatment. Although anemia is potentially modifiable, the effects of raising hemoglobin on mortality remain undetermined.