Respirology : official journal of the Asian Pacific Society of Respirology
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Randomized Controlled Trial
Roflumilast in Asian patients with COPD: A randomized placebo-controlled trial.
Roflumilast, an oral, selective phosphodiesterase 4 inhibitor, has been shown to reduce exacerbations and improve pulmonary function in patients with COPD. This study examined the efficacy, safety and tolerability of roflumilast in Asian patients with COPD. ⋯ Roflumilast, 500 µg once daily, improves pulmonary function in Asian patients with COPD. The safety and tolerability of roflumilast in this population was similar to that in a Caucasian population.
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ARDS is characterized by bilateral pulmonary infiltrates and refractory hypoxemia attributed to V/Q mismatch. We used dynamic CT to characterize changes in lung composition, regional perfusion and tissue distribution in patients with ARDS in comparison with healthy subjects. ⋯ In patients with ARDS there are changes in both lung composition and the distribution of tissue and perfusion that may account in part for the physiological changes that define the syndrome.
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Clinical Trial
Effect of disability level on response to pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis.
It is unclear whether the severity of functional limitation resulting from IPF affects the response to pulmonary rehabilitation. The aim of this study was to compare the outcomes of rehabilitation in patients with IPF, who were grouped according to the Medical Research Council (MRC) dyspnoea scale. ⋯ The response to pulmonary rehabilitation in subjects with IPF varies depending on the MRC grade of dyspnoea, with little benefit being observed in subjects with severe functional limitation.
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Adrenergic β2 receptors (ADRB2) play an important role in regulating pulmonary function. Many previous studies have investigated possible associations between polymorphisms in the ADRB2 gene and asthma, but have yielded conflicting results. Furthermore, little is known regarding the possible role of the Arg19Cys polymorphism in susceptibility to asthma among Chinese. ⋯ The Arg19/Cys19 genotype was an independent risk factor for lower FEV₁% and FEV₁/FVC. Asthmatic patients with the Arg19/Arg19 genotype showed decreased responsiveness to albuterol. Furthermore, the Arg19/Arg16/Gln27 haplotype may contribute to increased susceptibility to asthma in the Chinese population.
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Patients with COPD who require prolonged weaning from invasive mechanical ventilation show poor long-term survival. Whether non-invasive home mechanical ventilation (HMV) has a beneficial effect after prolonged weaning has not yet been clearly determined. ⋯ These findings suggest that based on the potential for improvement in long-term survival, non-invasive HMV should be considered in patients with severe COPD and persistent chronic hypercapnic respiratory failure after prolonged weaning.