Randomized, placebo-controlled clinical trial of an aerosolized ß2-agonist for treatment of acute lung injury.
Am J Respir Crit Care Med
; 184(5): 561-8, 2011 Sep 01.
Article
em En
| MEDLINE
| ID: mdl-21562125
ABSTRACT
RATIONALE ß2-Adrenergic receptor agonists accelerate resolution of pulmonary edema in experimental and clinical studies. OBJECTIVES:
This clinical trial was designed to test the hypothesis that an aerosolized ß2-agonist, albuterol, would improve clinical outcomes in patients with acute lung injury (ALI).METHODS:
We conducted a multicenter, randomized, placebo-controlled clinical trial in which 282 patients with ALI receiving mechanical ventilation were randomized to receive aerosolized albuterol (5 mg) or saline placebo every 4 hours for up to 10 days. The primary outcome variable for the trial was ventilator-free days. MEASUREMENTS AND MAINRESULTS:
Ventilator-free days were not significantly different between the albuterol and placebo groups (means of 14.4 and 16.6 d, respectively; 95% confidence interval for the difference, -4.7 to 0.3 d; P = 0.087). Rates of death before hospital discharge were not significantly different between the albuterol and placebo groups (23.0 and 17.7%, respectively; 95%confidence interval for the difference,-4.0 to 14.7%;P = 0.30). In the subset of patients with shock before randomization, the number of ventilator-free days was lower with albuterol, although mortality was not different. Overall, heart rates were significantly higher in the albuterol group by approximately 4 beats/minute in the first 2 days after randomization, but rates of new atrial fibrillation (10% in both groups) and other cardiac dysrhythmias were not significantly different.CONCLUSIONS:
These results suggest that aerosolized albuterol does not improve clinical outcomes in patients with ALI. Routine use of ß2-agonist therapy in mechanically ventilated patients with ALI cannot be recommended. Clinical trial registered with www.clinicaltrials.gov (NCT 00434993).
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Albuterol
/
Lesão Pulmonar Aguda
/
Agonistas de Receptores Adrenérgicos beta 2
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Respir Crit Care Med
Assunto da revista:
TERAPIA INTENSIVA
Ano de publicação:
2011
Tipo de documento:
Article