British journal of diseases of the chest
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Randomized Controlled Trial Clinical Trial
Effect of terbutaline administered from metered dose inhaler (2 mg) and subcutaneously (0.25 mg) on tracheobronchial clearance in mild asthma.
Tracheobronchial mucus clearance was measured in nine mild asthmatics, using an objective radioaerosol technique, on 3 separate days at intervals of 1 week. Immediately after radioaerosol inhalation, drug or placebo was administered via subcutaneous injection (SC) plus metered dose inhaler (MDI)--2 puffs. ⋯ Changes in lung mucociliary clearance showed an inverse relationship to baseline clearance of both proximal and distal ciliated airways following inhaled terbutaline, whereas terbutaline SC related inversely only to baseline clearance of the distal ciliated airways. This may reflect the surface concentrations of drug, established by each route.
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Randomized Controlled Trial Clinical Trial
The effect of indomethacin on breathlessness in patients with diffuse parenchymal disease of the lung.
We have shown in a previous study that indomethacin reduced breathlessness in normal subjects during exercise. In a double-blind randomized study we have determined the effects of both acute (50 mg) and chronic (25 mg twice daily for 7 days) oral treatment with indomethacin on breathlessness induced by exercise in patients with diffuse parenchymal disease of the lung. ⋯ There was no significant change in the distance walked in 6 minutes after any of the treatments. Possible explanations for the differing effects on breathlessness observed in normal subjects and in patients are discussed.
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Randomized Controlled Trial Clinical Trial
A study of the use of ultrasonically nebulized lignocaine for local anaesthesia during fibreoptic bronchoscopy.
The use of nebulized lignocaine, with and without intravenous diazepam premedication, was compared with lignocaine given by bolus in 52 patients undergoing fibreoptic bronchoscopy (FOB). Changes in airflow, cardiac rhythm, and transcutaneous PO2 were recorded, and patient acceptability, blood lignocaine levels, and the duration of the procedure were also monitored. ⋯ Nebulized lignocaine without diazepam was acceptable to the patients and was not associated with the significant (P less than 0.03) falls in transcutaneous PO2 which followed diazepam administration. Nebulized lignocaine, with and without, diazepam premedication is a safe, effective and acceptable method of inducing topical anaesthesia for FOB.
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Serial arterial blood gases were measured during fibreoptic bronchoscopy in 26 patients with diffuse interstitial lung disease. All those having transbronchial biopsy with or without bronchoalveolar lavage, performed breathing room air, showed significant falls in PaO2, at the time of passage of the bronchoscope through the vocal cords both at the beginning and end of the procedure. ⋯ Cessation of the supplementary oxygen 30 minutes after withdrawal of the bronchoscope did not result in rebound hypoxaemia. Bronchoalveolar lavage and transbronchial biopsy can be performed safely in patients with diffuse interstitial lung disease without significant hypoxaemia developing, if oxygen is started before the procedure and continued for 30 minutes after withdrawal of the bronchoscope.